Prevention of surgical site infection under different ventilation systems in operating room environment

doi:10.1007/s11783-020-1327-9

Front. Environ. Sci. Eng.

2021, Vol. 15

Issue (3) : 36 https://doi.org/10.1007/s11783-020-1327-9

RESEARCH ARTICLE

Prevention of surgical site infection under different ventilation systems in operating room environment

Zhijian Liu¹(

), Haiyang Liu¹, Hang Yin², Rui Rong¹, Guoqing Cao³(

), Qihong Deng⁴

¹. Department of Power Engineering, North China Electric Power University, Baoding 071003, China
². Department of Civil Engineering, Technical University of Denmark, Copenhagen, DK-2800 Kgs, Denmark
³. Institute of Building Environment and Energy, China Academy of Building Research, Beijing 100013, China
⁴. School of Energy Science and Engineering, Central South University, Changsha 410083, China

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Abstract

• The effectiveness of four different ventilation systems was compared in depth.

• Airflow and bacteria-carrying particles concentration were quantitatively analyzed.

• Vertical laminar airflow with high airflow rate could not achieve desired effect.

• Temperature-controlled airflow ventilation could guarantee air cleanliness.

Biological particles in the operating room (OR) air environment can cause surgical site infections (SSIs). Various ventilation systems have been employed in ORs to ensure an ultraclean environment. However, the effect of different ventilation systems on the control of bacteria-carrying particles (BCPs) released from the surgical staff during surgery is unclear. In this study, the performance of four different ventilation systems (vertical laminar airflow ventilation (VLAF), horizontal laminar airflow ventilation (HLAF), differential vertical airflow ventilation (DVAF), and temperature-controlled airflow ventilation (TAF)) used in an OR was evaluated and compared based on the spatial BCP concentration. The airflow field in the OR was solved by the Renormalization Group (RNG) k-e turbulence model, and the BCP phase was calculated by Lagrangian particle tracking (LPT) and the discrete random walk (DRW) model. It was found that the TAF system was the most effective ventilation system among the four ventilation systems for ensuring air cleanliness in the operating area. This study also indicated that air cleanliness in the operating area depended not only on the airflow rate of the ventilation system but also on the airflow distribution, which was greatly affected by obstacles such as surgical lamps and surgical staff.

Keywords Operating room (OR) Bacteria-carrying particles (BCPs) Surgical site infections (SSIs) Ventilation

Corresponding Author(s): Zhijian Liu,Guoqing Cao

Issue Date: 26 August 2020

Cite this article:

Zhijian Liu,Haiyang Liu,Hang Yin, et al. Prevention of surgical site infection under different ventilation systems in operating room environment[J]. Front. Environ. Sci. Eng., 2021, 15(3): 36.

URL:

https://academic.hep.com.cn/fese/EN/10.1007/s11783-020-1327-9
https://academic.hep.com.cn/fese/EN/Y2021/V15/I3/36

Fig.1 Model description of the ORs: (a) VLAF, (b) HLAF, (c) DVAF, (d) TAF.

Tab.1 Major characteristics of the four ventilation systems

Tab.2 Simulation parameters of the operating room

Fig.2 Schematic of the sample point locations.

Fig.3 Hospital-based ISO class-5 cleanroom: (a) The layout of the cleanroom and location of measurement points, (b) Comparison of experimental and simulation velocity values.

Fig.4 LPT and DRW model validation: (a) Ventilation room schematic, (b) Comparison of experimental and simulated values of particle concentration at different X positions in the center plane.

Fig.5 Velocity vector and BCP concentration distribution for (a) VLAF, (b) HLAF, (c) DVAF, and (d) (TAF).

Fig.6 The BCP concentration at each sample point (10 CFU/m³ was the recommended limit for clean operating. areas).

Fig.7 The BCP concentration at each sample point: (a) VLAF; (b) HLAF; (c) DVAF; (d) TAF (10 CFU/m³ was the recommended limit for clean operating areas).

Fig.8 Removal fraction of BCPs from the human body by different ventilation systems.

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