Knochen H, Hübner N-O, Below H, Assadian O, Külpmann R, Kohlmann T, Hildebrand K, Clemens S, Bartels C, Kramer A
Institut für Hygiene und Umweltmedizin, Universität Greifswald.
Klin Monbl Augenheilkd. 2010 Nov;227(11):871-8. doi: 10.1055/s-0029-1245657. Epub 2010 Sep 20.
The necessity for routine disinfection of floors between two surgical procedures or disinfection only after visible contamination was assessed in two identical ophthalmological operating theatres equipped with laminar air flow ventilation.
Over a period of four weeks, one of the two tested operating rooms was disinfected after every surgical procedure, and the other only in the case of visible contamination. This regimen was inverted every week. To compare the air quality, particle count and total bacteria count were measured inside and outside the laminar air flow. Additionally, bacteria count was measured in the operating field, consisting of the operating table and the instrument tray. Patients were monitored for surgical site infection over a period of one year after operation.
No difference in particle count or number of viable bacteria was found between the two investigated procedures. Also, no wound infections were observed after one year of surveillance for surgical site infection.
It appears that frequent cleaning disinfection of floors is not necessary if a laminar air flow ventilation system is installed. Under these conditions, targeted disinfection of visibly soiled surfaces appears to be sufficient. Generally, the duration of surgical procedures should be kept as short as possible.
在两个配备层流通风的相同眼科手术室中,评估在两台外科手术之间对地板进行常规消毒的必要性,或仅在可见污染后进行消毒的必要性。
在四周的时间里,两个测试手术室中的一个在每次手术后进行消毒,另一个仅在出现可见污染的情况下进行消毒。这种方案每周颠倒一次。为了比较空气质量,在层流内部和外部测量颗粒计数和总细菌计数。此外,在由手术台和器械托盘组成的手术区域测量细菌计数。术后对患者进行了一年的手术部位感染监测。
在两种研究程序之间,颗粒计数或活菌数量没有差异。此外,在对手术部位感染进行一年的监测后,未观察到伤口感染。
如果安装了层流通风系统,似乎没有必要频繁清洁消毒地板。在这些条件下,对明显污染的表面进行有针对性的消毒似乎就足够了。一般来说,手术时间应尽可能缩短。