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Unnecessary door openings increase SSI, contamination risk in OR

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Many unnecessary door openings that can introduce air contamination and jeopardize sterility regularly occur in hospital operating rooms, according to data presented at ECCMID 2016.

“Inappropriate staff behaviors can lead to environmental contamination in the operating room and subsequent surgical site infection (SSI),” the researchers wrote.

The researchers performed a multicenter observational study that included 13 operating rooms (OR) in 10 hospitals, five of which were university-based and five that were public. They included 26 cardiac surgeries that required a full median sternotomy and 34 orthopedic surgeries to perform total hip or knee replacement.

Wireless inertial sensors fixed on the OR doors were used to observe their openings. For each surgical procedure, the researchers performed three microbiological air counts — continuous particle counts of 0.3 µm, 0.5 µm and 5 µm particles — and one bacteriological sample of the wound site.

The researchers said the median number of doors opening was 29 per hour in both cardiac and orthopedic surgeries. They found that OR doors remained open a combined average of 43 minutes during cardiac surgery, or 13.5% of each procedure, and 36 minutes in orthopedic surgery, or 23% of the surgical duration. The highest frequency of door openings occurred between wound closure and patient exit (median, 20.1 openings/hr) and from patient entry to incision (median, 13.2 openings/hr).

Door openings occurred more frequently in university-based hospitals than in public hospitals. (P < .01), according to the investigators. In addition, the number of doors opening from skin incision to wound closure affected the 0.5 µm (P < .01) and 5 µm (P < .02) particle counts.

“Door openings affected air contamination, potentially jeopardizing operating room sterility,” the researchers wrote. “The causes and influences of behaviors in the OR must be evaluated to identify ways to reduce the associated risks.”

Reference:

Birgand G, et al. Abstract 4129. Presented at: European Congress of Clinical Microbiology and Infectious Diseases; April 9-12, 2016; Amsterdam.

Disclosure: Infectious Disease News was unable to confirm relevant financial disclosures at the time of publication.