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  • Title: Air contamination for predicting wound contamination in clean surgery: A large multicenter study.
    Author: Birgand G, Toupet G, Rukly S, Antoniotti G, Deschamps MN, Lepelletier D, Pornet C, Stern JB, Vandamme YM, van der Mee-Marquet N, Timsit JF, Lucet JC.
    Journal: Am J Infect Control; 2015 May 01; 43(5):516-21. PubMed ID: 25752955.
    Abstract:
    BACKGROUND: The best method to quantify air contamination in the operating room (OR) is debated, and studies in the field are controversial. We assessed the correlation between 2 types of air sampling and wound contaminations before closing and the factors affecting air contamination. METHODS: This multicenter observational study included 13 ORs of cardiac and orthopedic surgery in 10 health care facilities. For each surgical procedure, 3 microbiologic air counts, 3 particles counts of 0.3, 0.5, and 5 μm particles, and 1 bacteriologic sample of the wound before skin closure were performed. We collected data on surgical procedures and environmental characteristics. RESULTS: Of 180 particle counts during 60 procedures, the median log10 of 0.3, 0.5, and 5 μm particles was 7 (interquartile range [IQR], 6.2-7.9), 6.1 (IQR, 5.4-7), and 4.6 (IQR, 0-5.2), respectively. Of 180 air samples, 50 (28%) were sterile, 90 (50%) had 1-10 colony forming units (CFU)/m(3) and 40 (22%) >10 CFU/m(3). In orthopedic and cardiac surgery, wound cultures at closure were sterile for 24 and 9 patients, 10 and 11 had 1-10 CFU/100 cm(2), and 0 and 6 had >10 CFU/100 cm(2), respectively (P < .01). Particle sizes and a turbulent ventilation system were associated with an increased number of air microbial counts (P < .001), but they were not associated with wound contamination (P = .22). CONCLUSIONS: This study suggests that particle counting is a good surrogate of airborne microbiologic contamination in the OR.
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