Findings from a multicenter, observational study conducted in France revealed an association between the movements of staff in the operating room, or OR, during surgery and the risk for surgical site infections.
“We aimed to objectively describe and assess staff behaviors in the OR and their variability by recording staff movements using a motion tracking system and door-openings detection system,” Gabriel Birgand, PhD, a researcher affiliated with several institutions in Paris, and colleagues wrote. “We also assessed correlations between movements of the OR personnel and the [surgical site infection (SSI)] risk, as approximated by surrogates of the exogenous infectious risk, in a panel of ORs from two clean surgical specialties.”
Birgand and colleagues included 13 ORs from 10 hospitals in France that performed planned cardiac and orthopedic surgery, such as total hip or knee replacement. Inertial sensors were fixed on the doors to collect data on door openings during surgery, while eight infrared cameras captured staff movements. For every surgical procedure included in the study, Birgand and colleagues collected three microbiological air counts, longitudinal particle counts and one bacteriological sample of the wound before the skin was closed.
According to the study, 34 orthopedic and 25 cardiac procedures, performed between May 14, 2013, and Dec. 20, 2013, were included in the final analysis. The researchers observed an independent association between the median frequency of door openings from incision to closure and an increased particle count of log10 0.3 m. The median frequency of door openings during a procedure was also independently associated with air microbial count, but it was not significantly correlated with wound contamination before closure (P = .32), they reported. The number of people in the operating room and the cumulated movements of the surgical team were both associated with log10 0.3 m particle counts.
The findings “demonstrated a previously missing association between intraoperative staff movements and surrogates of the exogenous risk of surgical site infections,” Birgand and colleagues wrote.
“This study highlights the importance of the intraoperative discipline of staff, suggesting that a restriction of staff movements and door openings may prevent airborne contamination and the associated SSI risk,” they wrote. “The awareness of surgical staff in this field may improve behaviors and quality of care.” – by Marley Ghizzone
Disclosures: The authors report no relevant financial disclosures.