The main target of this document is to evaluate the link between the presence of contaminants in the operating room air, and the type of ventilation system used for the diffusion of air inside it. Although is widely shared the idea that the level of total and microbiological air contamination in the operating room has a direct influence on the risk of infections, the debate on which is the most effective ventilation system to prevent onset of surgical site infection (SSI), is still open. This study presents the results obtained during the environmental monitoring campaign, performed by external specialized technical personnel in collaboration with Air Lab over a period of about 8 years, on 31 hospital sites, for a total of 177 operating theatres (58 equipped with a unidirectional airflow ventilation system and 119 equipped with a mixing airflow ventilation system). Inert and viable airborne particle concentration were measured at different points and different occupational states (“At Rest” and “Operational”) of the operating rooms subjected to evaluation. Additional parameters were detected and recorded such as the number of people present during operations, the type of technical clothing adopted by the medical staff, the thermo-hygrometric conditions in the environment, the possible opening of the access door to the operating room, as well as the range and speed supply air and the type of terminal filter used. The results obtained have shown that operating theatres equipped with a unidirectional airflow ventilation system allow to obtain a concentration of inert and viable airborne particle, within the work area closest to the patient's surgical wound, lower than the traditional mixing systems, thus reducing the risk of infection.
L’obiettivo primario di questo studio è quello di valutare il legame esistente tra la presenza di contaminanti aeroportati in sala operatoria e la soluzione impiantistica utilizzata per la diffusione dell’aria al suo interno. Pur essendo largamente condivisa l’idea che il livello di contaminazione aeroportata, totale e microbiologica, dell’aria in sala operatoria abbia un’influenza diretta sul rischio di infezioni, il dibattito su quale sia il sistema di ventilazione più efficace per prevenire l’insorgenza di infezioni del sito chirurgico (SSI), è ancora aperto. Lo studio presenta i risultati ottenuti dall’analisi dei dati rilevati durante la campagna di monitoraggio ambientale, eseguita da personale tecnico specializzato esterno in collaborazione con Air Lab in un periodo di circa 8 anni, su 31 siti ospedalieri per un totale di 177 sale operatorie (58 dotate di un sistema di diffusione dell’aria di tipo unidirezionale e 119 dotate di un sistema di diffusione a miscelazione). Sono state misurate, in diversi punti e differenti stati occupazionali (“At Rest” ed “Operational”) delle sale operatorie sottoposte a valutazione, le concentrazioni di particolato totale e biologicamente attivo. Ulteriori parametri quali il numero di persone presenti durante le operazioni, il tipo abbigliamento tecnico adottato dallo staff medico, le condizioni termoigrometriche in ambiente, le aperture della porta di accesso alla sala operatoria, nonché la portata e la velocità dell’aria immissione ed il tipo di filtro terminale utilizzato, sono stati rilevati e registrati. I risultati ottenuti hanno evidenziato come le sale operatorie, equipaggiate con un sistema di diffusione a flusso unidirezionale, permettano di ottenere una concentrazione di particolato totale e biologicamente attivo, all’interno dell’area di lavoro più prossima alla ferita chirurgica del paziente, più bassa rispetto ai tradizionali sistemi a miscelazione, riducendo pertanto il rischio di infezione.
Ventilazione e controllo dei contaminanti nelle sale operatorie : analisi di lungo termine delle prestazioni in un campione di ospedali italiani
DALLA NAVE, EMILIANO
2018/2019
Abstract
The main target of this document is to evaluate the link between the presence of contaminants in the operating room air, and the type of ventilation system used for the diffusion of air inside it. Although is widely shared the idea that the level of total and microbiological air contamination in the operating room has a direct influence on the risk of infections, the debate on which is the most effective ventilation system to prevent onset of surgical site infection (SSI), is still open. This study presents the results obtained during the environmental monitoring campaign, performed by external specialized technical personnel in collaboration with Air Lab over a period of about 8 years, on 31 hospital sites, for a total of 177 operating theatres (58 equipped with a unidirectional airflow ventilation system and 119 equipped with a mixing airflow ventilation system). Inert and viable airborne particle concentration were measured at different points and different occupational states (“At Rest” and “Operational”) of the operating rooms subjected to evaluation. Additional parameters were detected and recorded such as the number of people present during operations, the type of technical clothing adopted by the medical staff, the thermo-hygrometric conditions in the environment, the possible opening of the access door to the operating room, as well as the range and speed supply air and the type of terminal filter used. The results obtained have shown that operating theatres equipped with a unidirectional airflow ventilation system allow to obtain a concentration of inert and viable airborne particle, within the work area closest to the patient's surgical wound, lower than the traditional mixing systems, thus reducing the risk of infection.File | Dimensione | Formato | |
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https://hdl.handle.net/10589/149599