The addition of a mobile ultra-clean exponential laminar airflow screen to conventional operating room ventilation reduces bacterial contamination to operating box levels

A mobile screen producing ultra-clean exponential laminar airflow (LAF) was investigated as an addition to conventional turbulent/mixing operating room (OR) ventilation (16 air changes/h). The evaluation was performed in a small OR (50 m 3) during 60 standardized operations for groin hernia including mesh implantation. The additional ventilation was used in 50 of the operations. The LAF passed from the foot-end of the OR table over the instrument and surgical area. Strict hygiene OR procedures including tightly woven and non-woven OR clothing were used. Sedimentation rates were recorded at the Level of the patients' chests (N = 60) (i.e. the air had passed the surgical team) and in the periphery of the OR. In addition bacterial. air contamination was studied above the patients' chests in all 10 operations without the additional LAF and in 12 with the LAF. The screen reduced the mean counts of sedimenting bacteria (cfu/m(2)/h) on the patients' chests from 775 without the screen to 355 (P = 0.0003). The screen also reduced the mean air counts of bacteria (cfu/m(3)) above the patients' chests from 27 to 9 (P = 0.0001). No significant differences in mean sedimentation rates (cfu/m(2)/h) existed in the periphery of the OR where 628 without and 574 with screen were recorded. During the follow-up period of six months no surgical site infections were detected. In conclusion when the mobile LAF screen was added to conventional OR ventilation the counts of aerobic airborne and sedimenting bacteria-carrying particles downstream of the surgical team were reduced to the levels achieved with complete ultra-clean LAF OR ventilation (operating box). (C) 2003 The Hospital Infection Society. Published by Elsevier Ltd. ALL rights reserved.