Operating room air delivery design to protect patient and surgical site results in particles released at surgical table having greater concentration along walls of the room than at the instrument tray

Jennifer A Wagner; Franklin Dexter; Damon G Greeley; Kevin Schreiber

doi:10.1016/j.ajic.2020.10.003

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Operating room air delivery design to protect patient and surgical site results in particles released at surgical table having greater concentration along walls of the room than at the instrument tray

Journal article

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Peer reviewed

Operating room air delivery design to protect patient and surgical site results in particles released at surgical table having greater concentration along walls of the room than at the instrument tray

Jennifer A Wagner, Franklin Dexter, Damon G Greeley and Kevin Schreiber

American journal of infection control, Vol.49(5), pp.593-596

05/2021

DOI: 10.1016/j.ajic.2020.10.003

PMCID: PMC7544698

PMID: 33039512

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Abstract

•Modern air handling systems for operating rooms protect the patient and surgical team.•Concentrations of air particles are greater along walls than at the instrument table.•Fewer particles are found at the center of the operating room.•Stepping 2 m away from patient would not protect personnel in operating rooms. During the coronavirus disease 2019 (COVID-19) pandemic, recommendations have included that personnel not involved in procedures releasing airborne contaminants reduce their exposure by moving >2 m away. We tested whether air particle concentrations in operating rooms (ORs) are greater in the periphery, downstream from the supply airflow. We analyzed data from 15 mock surgical procedures performed in 3 ORs. Two ORs were modern, one with a single large diffuser system above the surgical table, and the other using a multiple diffuser array design. An air particle counting unit was located on the instrument table, another adjacent to an air return grille. Concentrations of air particles were greater at return grille than instrument table for the single large diffuser at 26 air exchanges per hour, and the multiple diffuser array at both 26 and 20 air exchanges per hour (all P ≤ .0044), including during electrocautery (all P ≤ .0072). The ratios of concentrations, return grille versus instrument table, were greater during electrocautery for 0.5 to 1.0-micron particles and 1.0 to 5.0-micron particles (both P < .0001). Modern OR airflow systems are so effective at protecting the surgical field and team from airborne particles emitted during surgery that concentrations of particles released at the OR table are greater at the OR walls than near the center of the room.

Operating room airflow

Operating room management

Airborne contaminants

Coronavirus disease 2019 (COVID-19)

Details

Title: Subtitle: Operating room air delivery design to protect patient and surgical site results in particles released at surgical table having greater concentration along walls of the room than at the instrument tray
Creators: Jennifer A Wagner - OnSite-LLC, Indianapolis, IN
Franklin Dexter - Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, IA
Damon G Greeley - OnSite-LLC, Indianapolis, IN
Kevin Schreiber - SLD Technology, Inc., Portland, OR
Resource Type: Journal article
Publication Details: American journal of infection control, Vol.49(5), pp.593-596
DOI: 10.1016/j.ajic.2020.10.003
PMID: 33039512
PMCID: PMC7544698
NLM abbreviation: Am J Infect Control
ISSN: 0196-6553
eISSN: 1527-3296
Publisher: Elsevier Inc
Grant note: SLD Technology, Inc University of Iowa (https://doi.org/10.13039/100008893) OnSite-LLC
Language: English
Date published: 05/2021
Academic Unit: Health Management and Policy; Anesthesia
Record Identifier: 9984077380102771

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