Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty? | Aerobiotix

Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty?

Javad Parvizi MS, MD, FRCS, Sue Barnes RN, CIC, Noam Shohat MD, Charles E. Edmiston Jr., MS, PhD
American Journal of Infection Control (2017)
Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI.

Background

Although the pharmaceutic and computer industries enforce stringent air quality standards on their manufacturing processes, there is currently no U.S. standard for acceptable air quality within the OR environment.

Objective

This review documents the contribution of air contamination to the etiology of periprosthetic joint infection, and evidence for selective innovative strategies to reduce the risk of intraoperative microbial aerosols.

Results and Conclusions

To meet the future challenge of reducing the risk of PJIs and other implant-related infections, updated quantitative air quality standards for the OR (e.g., those in development for the World Health Organization) are required that are based on state-of-the-art real-time microbial aerosol testing. If we are to have a measurable impact on reducing patient morbidity and mortality that is often associated with PJI, all surgical stakeholders must continue to evaluate and embrace innovative operative techniques along with evidence-based adjunctive risk re-duction strategies, improving patient outcomes and preserving valuable health care resources.