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Archive October 2019 XX, No. 10

How Clean Is Your OR Air?

If you think the manual cleaning of OR surfaces is enough to prevent SSIs, you're not addressing a more invisible danger.

Maureen Spencer

Maureen Spencer, MEd, BSN, RN, CIC, FAPIC


STIRRING THINGS UP The more people, movement and activity there is in an OR, the more likely contaminants are to become airborne.

You can scrub every inch of an OR until your elbows ache, but the minute someone steps into that clean space the air becomes contaminated simply because of their presence. They're exhaling bacteria. Their hair and skin and clothes are shedding it. All of these contaminants released from surgical team members and patients float through the air, riding air currents in the room until they settle onto instruments and into incisions. You might not be able to see airborne pathogens, but they're there, and they pose a potential danger to every patient you treat.

The good news is that products and technologies have emerged to address airborne bioburden, and that awareness of the issue is increasing throughout the industry. What can you do to keep the air clean in your ORs? Proper ventilation definitely helps, but it's not a cure-all. You need a combination of protocols and technology to address the issue as fully as you can.

Airborne issues

One thing that's difficult about this issue is that we don't have OR air contamination standards. It's also difficult to measure airborne contaminants. But here is what we know: More and more research shows a connection between aerosolized bacteria and surgical site infections.

Although OR air quality should be a concern for all surgeries, it's particularly important during any procedure involving implants, such as orthopedics, where there's a lot of manipulation and sawing and reaming, and a lot of activity and movement of staff. Just a few organisms getting on an implant can start to grow rapidly once it's inside the body.

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