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Surgical Smoke and Airborne Microbial Contamination in Operating Theatres: Influence of Ventilation and Surgical Phases

Author

Listed:
  • Francesco Romano

    (Dipartimento di Energia, Politecnico di Milano, 20125 Milan, Italy)

  • Samanta Milani

    (Dipartimento di Energia, Politecnico di Milano, 20125 Milan, Italy)

  • Jan Gustén

    (Building Services Engineering, Chalmers University of Technology, SE-41296 Gothenburg, Sweden)

  • Cesare Maria Joppolo

    (Dipartimento di Energia, Politecnico di Milano, 20125 Milan, Italy)

Abstract

Air cleanliness is a crucial factor in operating theatres (OTs), where the health of patients and staff must be preserved by controlling air contamination. Particular attention must be paid to ultrafine particles (UFPs) size range, generated for instance by electrosurgical instruments (ESTs). OT contamination is also affected by ventilation systems, medical staff and their gowning system, staff routines, instruments, etc. This comparative study is based on experimental measurements of airborne microbial contamination and UFPs carried out during real ongoing surgeries in two OTs equipped with upward displacement ventilation (UWD) and hybrid ventilation, with unidirectional airflow on the operating table and peripheral mixing (UDAF+Mixing) ventilation systems. Airborne contamination concentration at the exit grilles has been analyzed as function of four different surgical phases normally performed during an operation. Results highlight that airborne contamination is influenced by the activities carried out during the surgical phases. EST usage affects the contamination level more than staff size during operation observed. Colony forming unit (CFU) values in the protected area close to the patient’s wound are influenced more by the type of ventilation system than by surgical phases. CFU values decrease by 18 to 50 times from the UWD system to the hybrid one. The large airflow volumes supply together with high air velocities in OTs equipped with UDAF+Mixing systems guarantee a better and a safer airborne contamination control for patients and medical team in comparison with UWD systems.

Suggested Citation

  • Francesco Romano & Samanta Milani & Jan Gustén & Cesare Maria Joppolo, 2020. "Surgical Smoke and Airborne Microbial Contamination in Operating Theatres: Influence of Ventilation and Surgical Phases," IJERPH, MDPI, vol. 17(15), pages 1-13, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:15:p:5395-:d:390399
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    References listed on IDEAS

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    1. Ewa Brągoszewska & Izabela Biedroń, 2018. "Indoor Air Quality and Potential Health Risk Impacts of Exposure to Antibiotic Resistant Bacteria in an Office Rooms in Southern Poland," IJERPH, MDPI, vol. 15(11), pages 1-17, November.
    2. Maria Teresa Montagna & Serafina Rutigliano & Paolo Trerotoli & Christian Napoli & Francesca Apollonio & Alessandro D’Amico & Osvalda De Giglio & Giusy Diella & Marco Lopuzzo & Angelo Marzella & Simon, 2019. "Evaluation of Air Contamination in Orthopaedic Operating Theatres in Hospitals in Southern Italy: The IMPACT Project," IJERPH, MDPI, vol. 16(19), pages 1-11, September.
    3. Francesco Romano & Jan Gustén & Stefano De Antonellis & Cesare M. Joppolo, 2017. "Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres," IJERPH, MDPI, vol. 14(2), pages 1-13, January.
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    1. Francesco Romano & Samanta Milani & Roberto Ricci & Cesare Maria Joppolo, 2020. "Operating Theatre Ventilation Systems and Their Performance in Contamination Control: “At Rest” and “In Operation” Particle and Microbial Measurements Made in an Italian Large and Multi-Year Inspectio," IJERPH, MDPI, vol. 17(19), pages 1-16, October.

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