American journal of infection control · 2026
Impact of door openings, staff members and operation length on particle contamination and surgical site infections during acute and elective orthopedic implant surgery: an observational study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Stålfelt Frans, Caous Josefin Seth, Malchau Henrik, Malchau Karin Svensson
Аннотация
BACKGROUND: Surgical site infection (SSI) is a complication associated with patient morbidity and increased healthcare costs. Its etiology is multifactorial, including intraoperative air contamination. This study aimed to evaluate how door openings and operating room (OR) staff presence, influence particle dispersion during orthopedic implant surgery, and to explore associations with SSI risk.
METHOD: Particle counters, door sensors, and camera-based people counting was installed in orthopedic ORs at Sahlgrenska University Hospital, Sweden between 2021 and 2025. Data on reoperations due to SSI were obtained from the Swedish Arthroplasty Register, the Swedish Fracture Register, and a local surgical scheduling system.
RESULTS: Among 5,105 surgeries, 138 (2.7%) had reported SSI. Each additional person in the OR increased 1.0- and 5.0-µm particle concentrations by 1,503 particles/m³ (95% CI 545-2,462; p=0.002) and 99 particles/m³ (95% CI 34-163; p=0.003), respectively. Staff presence was similar between SSI and non-SSI cases (5.5 vs 5.0). SSI cases had 18-minute longer operative times, 1.5-fold more door openings, and 3.6% higher SSI odds per additional opening.
DISCUSSION AND CONCLUSION: Real-time monitoring provides important insights into intraoperative particle dynamics. Further data are needed to develop robust predictive models for SSI risk and to clarify causal relationships between OR behavior and infection outcomes.
METHOD: Particle counters, door sensors, and camera-based people counting was installed in orthopedic ORs at Sahlgrenska University Hospital, Sweden between 2021 and 2025. Data on reoperations due to SSI were obtained from the Swedish Arthroplasty Register, the Swedish Fracture Register, and a local surgical scheduling system.
RESULTS: Among 5,105 surgeries, 138 (2.7%) had reported SSI. Each additional person in the OR increased 1.0- and 5.0-µm particle concentrations by 1,503 particles/m³ (95% CI 545-2,462; p=0.002) and 99 particles/m³ (95% CI 34-163; p=0.003), respectively. Staff presence was similar between SSI and non-SSI cases (5.5 vs 5.0). SSI cases had 18-minute longer operative times, 1.5-fold more door openings, and 3.6% higher SSI odds per additional opening.
DISCUSSION AND CONCLUSION: Real-time monitoring provides important insights into intraoperative particle dynamics. Further data are needed to develop robust predictive models for SSI risk and to clarify causal relationships between OR behavior and infection outcomes.