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杂交手术室中使用天花板安装系统进行成像对手术过程中集落形成单位水平的影响。

Effect of using ceiling-mounted systems for imaging in hybrid operating rooms on the level of colony-forming units during surgery.

机构信息

The Netherlands Organisation for Applied Scientific Research TNO, Delft, The Netherlands.

The Netherlands Organisation for Applied Scientific Research TNO, Delft, The Netherlands.

出版信息

J Hosp Infect. 2019 Sep;103(1):e61-e67. doi: 10.1016/j.jhin.2018.10.016. Epub 2018 Oct 23.

Abstract

BACKGROUND

Large imaging systems in hybrid operating rooms are used increasingly. However, the effect of these ceiling-mounted imaging systems on air quality during surgical procedures has not been studied to date.

AIM

To evaluate the level of colony-forming units (cfu)/m near the surgical wound and near the instrument table during surgery.

METHODS

Measurements were performed in four hybrid operating rooms at four different hospitals. During surgical procedures, at least three samples were taken with active slit air samplers. At the end of the day's surgical schedule, simulations involving movement of the ceiling-mounted system were also performed. The threshold value for the average cfu level during a surgical procedure was set at ≤10 cfu/m, and for individual samples was set at ≤30 cfu/m.

RESULTS

The median value near the surgical wound was 1 cfu/m and at the instrument table was 2 cfu/m. However, in one hybrid operating room (two procedures out of 16) where the instrument table was not positioned directly under the unidirectional flow (UDF) system, the threshold value for the average cfu level at the instrument table was exceeded. For one of these procedures, the maximum value for an individual sample was also exceeded.

CONCLUSIONS

A ceiling-mounted imaging system in combination with a UDF system can result in cfu levels near the surgical wound and at the instrument table that are well below the threshold value of 10 cfu/m during surgery. If the instrument table is not positioned directly under the UDF system, the cfu level is higher.

摘要

背景

杂交手术室中越来越多地使用大型成像系统。然而,迄今为止,尚未研究这些天花板安装的成像系统对手术过程中空气质量的影响。

目的

评估手术过程中靠近手术伤口和靠近器械台的集落形成单位(cfu)/m 的水平。

方法

在四家不同医院的四个杂交手术室进行了测量。在手术过程中,使用主动狭缝空气采样器至少采集了三个样本。在手术当天的手术计划结束时,还模拟了天花板安装系统的移动。手术过程中平均 cfu 水平的阈值设定为≤10 cfu/m,个体样本的阈值设定为≤30 cfu/m。

结果

靠近手术伤口处的中位数为 1 cfu/m,靠近器械台处为 2 cfu/m。然而,在一个杂交手术室(16 个程序中的两个)中,器械台未直接定位在单向流(UDF)系统下方,仪器台的平均 cfu 水平的阈值被超过。对于其中一个程序,单个样本的最大值也超过了阈值。

结论

天花板安装的成像系统与 UDF 系统结合使用,可以在手术过程中使靠近手术伤口和器械台的 cfu 水平远低于 10 cfu/m 的阈值。如果器械台未直接位于 UDF 系统下方,则 cfu 水平会更高。

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