How to get cheap clean air? Implementation of an affordable high-efficient air filtration ventilation system for operating theatres in a low-resource setting.

AIM: Clean air in the operating theatre (OT) is crucial for safe surgery in order to prevent surgical site infections. Air filtration devices are standard in most OT as required by international guidelines and regulations. However, in low-resource settings, common air filtration devices are only scarcely found in OT, mainly due to high cost. Context-adapted low-cost solutions for clean air in OT are urgently needed but not available. The aim of this study was to assess the effectiveness of a new mechanical air filtration system for OTs, to describe its technical details and compare its performance with DIN/ISO standards and natural window ventilation, at a district hospital in Mbouo, Cameroon.

METHODS

An affordable (3,500 €) high-efficient air filtration system was developed, locally constructed and implemented. An evaluation was done after 4 years of regular use, comparing the system with ISO/DIN guidelines.

RESULTS

The device was still working properly after 4 years of regular use without any maintenance. The air filtration system reduced particles in the OT by >97%. The microbial contamination in the OT air was reduced by 72% after starting the device. Although it is not fully compliant with all DIN/ISO requirements, the ventilation system greatly improved the cleanliness of the OT air compared to 'natural' window-based ventilation.

CONCLUSIONS

This pilot study showed the feasibility and quality of a new context-adapted affordable air filtration device for OT in low-resource settings. Further studies and upscaling are needed. Construction plans are freely available.