Bioburden levels during total joints in ORs complying with US ventilation specifications

Editor's Note

This study from Baptist Health-Fort Smith, Arkansas, finds that the low-energy consumption ventilation system specified for in US operating rooms produces different zones of sterile protection from airborne microbe carrying particles (MCP) during total joint arthroplasties. The predominant source of MCPs are from personnel in the OR—an average human sheds 1,000 MCPs per minute.

A total of 80 total joint replacement cases were included in the analysis. Surgical helmet systems and strict protocols were used in all cases.

Of the 80 cases, 75 (94%) achieved desired benchmark levels of bioburden at the surgical site, while only 52 (65%) achieved desired levels at the back table zones.

No surgical site infections resulted at a minimum of 18 months’ follow-up.

The current US-approved ventilation design appears to achieve ultraclean air conditions at the surgical site, using strict protocols and surgical helmet systems, but higher levels of contamination are present at the back table zones, the researchers say.