Young Richard S, O'Regan David J
The General Infirmary at Leeds, UK.
Interact Cardiovasc Thorac Surg. 2010 Apr;10(4):526-9. doi: 10.1510/icvts.2009.227116. Epub 2010 Jan 25.
Surgical site infections (SSIs) remain a significant cause of postoperative complications. The risk of death from a medical error in a UK hospital remains one in 300. Increased theatre traffic has been identified as a modifiable determinant of SSI and surgical error. This cross-sectional study for the first time describes the pattern of theatre traffic in a UK cardiac centre. An electronic door counter and galaxy theatre management software (v3.4, iSOFT Banbury, UK) were used to calculate frequencies and rates of door opening during operations. Forty-six cases were analysed with 4273 door openings recorded. The median age of patients was 65 (range 43-75) with a median EuroSCORE of 5 (1-14). The mean frequency of door openings per case was 92.9 (45-205), with 19.2 (6.4-38.2) openings per hour. The theatre door was open for 10.7% of each hour of operating. Prolonged, acute and cases involving patients with higher EuroSCOREs demonstrated a trend towards increased opening. Door opening disturbs theatre airflow and results in increased air and wound contamination. It is also described as a contributor to surgical mistakes. Current levels of traffic are unacceptably high and represent a modifiable risk factor for SSI and error.
手术部位感染（SSIs）仍然是术后并发症的一个重要原因。在英国医院，因医疗差错导致死亡的风险仍为三百分之一。手术室人流量增加已被确定为手术部位感染和手术差错的一个可改变的决定因素。这项横断面研究首次描述了英国一家心脏中心的手术室人流量模式。使用电子门计数器和Galaxy手术室管理软件（v3.4，iSOFT Banbury，英国）来计算手术期间门开启的频率和速率。分析了46例病例，记录到4273次门开启。患者的中位年龄为65岁（范围43 - 75岁），欧洲心脏手术风险评估系统（EuroSCORE）的中位数为5（1 - 14）。每例手术门开启的平均频率为92.9次（45 - 205次），每小时开启19.2次（6.4 - 38.2次）。手术室的门在每小时的手术时间里有10.7%是打开的。手术时间延长、急症手术以及欧洲心脏手术风险评估系统评分较高的患者的病例显示出门开启次数增加的趋势。门的开启会扰乱手术室的气流，导致空气和伤口污染增加。它也被认为是手术失误的一个促成因素。目前的人流量水平高得令人无法接受，是手术部位感染和差错的一个可改变的风险因素。
