title: Airborne bacterial contamination during orthopedic surgery: A randomized controlled pilot trial.
abstract: OBJECTIVE
  Several factors such as lack of unidirectional, turbulent free laminar airflow, duration of surgery, patient warming system, or the number of health professionals in the OR have been shown or suspected to increase the number of airborne bacteria. The objective of this study was to perform a multivariate analysis of bacterial counts in the OR in patients during minor orthopedic surgery.
  
  
  METHODS
  Prospective, randomized pilot study.
  
  
  METHODS
  Medical University of Vienna, Austria.
  
  
  METHODS
  Eighty patients undergoing minor orthopedic surgery were included in the study.
  
  
  METHODS
  Surgery took place in ORs with and without a unidirectional turbulent free laminar airflow system, patients were randomized to warming with a forced air or an electric warming system.
  
  
  METHODS
  The number of airborne bacteria was measured using sedimentation agar plates and nitrocellulose membranes at 6 standardized locations in the OR.
  
  
  RESULTS
  The results of the multivariate analysis showed, that the absence of unidirectional turbulent free laminar airflow and longer duration of surgery increased bacterial counts significantly. The type of patient warming system and the number of health professionals had no significant influence on bacterial counts on any sampling site.
  
  
  CONCLUSIONS
  ORs with unidirectional turbulent free laminar airflow, and a reduction of surgery time decreased the number of viable airborne bacteria. These factors may be particularly important in critical patients with a high risk for the development of surgical site infections.
authors.affiliation: Medical University of Vienna, Department of Anesthesia, General Intensive Care and Pain Management, Vienna, Austria.
authors.forename: Ruken
authors.initials: R
authors.lastname: Oguz
authors.affiliation: Medical University of Vienna, Clinical Institute of Hospital Hygiene, Vienna, Austria.
authors.forename: Magda
authors.initials: M
authors.lastname: Diab-Elschahawi
authors.affiliation: Medical University of Vienna, Clinical Institute of Hospital Hygiene, Vienna, Austria.
authors.forename: Jutta
authors.initials: J
authors.lastname: Berger
authors.affiliation: Medical University of Vienna, Clinical Institute of Hospital Hygiene, Vienna, Austria.
authors.forename: Nicole
authors.initials: N
authors.lastname: Auer
authors.affiliation: Medical University of Vienna, Department of Anesthesia, General Intensive Care and Pain Management, Vienna, Austria.
authors.forename: Astrid
authors.initials: A
authors.lastname: Chiari
authors.affiliation: Medical University of Vienna, Clinical Institute of Hospital Hygiene, Vienna, Austria.
authors.forename: Ojan
authors.initials: O
authors.lastname: Assadian
authors.affiliation: Medical University of Vienna, Department of Anesthesia, General Intensive Care and Pain Management, Vienna, Austria. Electronic address: study@kimberger.at.
authors.forename: Oliver
authors.initials: O
authors.lastname: Kimberger
mesh_terms: D000391:Air Microbiology; D058491:Bacterial Load; D006801:Humans; D009873:Operating Rooms; D019637:Orthopedic Procedures / Q000009:adverse effects*; D019990:Perioperative Care / Q000592:standards; D010865:Pilot Projects; D011446:Prospective Studies; D017694:Rewarming / Q000009:adverse effects / Q000379:methods; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013997:Time Factors
keywords: Airborne bacterial deposition; Laminar flow; Operating room safety; Orthopedic surgery; Patient warming