Hartford Hospital, Heart and Vascular Institute, Hartford, Connecticut.
J Extra Corpor Technol. 2021 Jun;53(2):130-136. doi: 10.1182/ject-2100019.
A decrease in the infection rates in the operating room (OR) is attributable to advances in sterile technique; heating, ventilation, and air-conditioning (HVAC) filtration; and limiting the number of people entering and leaving the OR. However, some infection complications after open heart procedures have been linked to the discharge fans of surgical equipment, most notably from the LivaNova 3T. We believe that surgical infection within the OR may also be due to other devices with internal fans. The purpose of this study was to 1) identify surgical equipment with an internal fan and see how they affect the airflow in an OR, 2) use the equipment to positively affect airflow to possibly reduce the risk of surgical site infections, and 3) bring attention to the HVAC system ability to exchange air throughout the OR. By using a fog machine and multiple camera angles, we identified the devices that have an effect on the airflow. We saw that the direction of the intake vent of specific devices can change the direction of airflow and possibly help to remove air. Last, we showed how the current HVAC air exchange rate might not be enough to remove contaminated air within the OR. Understanding intake and discharge vents for all equipment is important because sterile contamination and wound infection may be minimized or mitigated completely by simply repositioning a few devices.
手术室(OR)感染率的降低归因于无菌技术的进步、加热、通风和空调(HVAC)过滤以及限制进出 OR 的人数。然而,一些心脏直视手术后的感染并发症与手术设备的排气扇有关,尤其是来自 LivaNova 3T 的排气扇。我们认为,手术室内部的手术感染也可能是由于其他带有内部风扇的设备引起的。本研究的目的是:1)确定带有内部风扇的手术设备,观察它们如何影响 OR 中的气流;2)使用设备对气流产生积极影响,以降低手术部位感染的风险;3)引起人们对 HVAC 系统在整个 OR 中交换空气的能力的关注。通过使用雾机和多个摄像头角度,我们确定了对气流有影响的设备。我们发现,特定设备的进风口方向可以改变气流方向,并可能有助于排出空气。最后,我们展示了当前的 HVAC 空气交换率可能不足以清除 OR 内的污染空气。了解所有设备的进风口和排风口非常重要,因为通过简单地重新定位几个设备,就可以将无菌污染和伤口感染降到最低或完全消除。