First Author: R.Lapid-Gortzak THE NETHERLANDS
Co Author(s): R. Traversari J. van der Linden I. van der Meulen C. Nieuwendaal A. Bode
Purpose:
Controlling air quality reduces the number of airborne organisms by 98%. In preventing post-operative infections, air quality is a major issue, together with tissue contamination of the patient (the patientÂ’s own flora). The clothing and behavior of the surgical staff are other factors contributing to the rate of infection. The use of Unidirectional Flow (UDF) units as an infection preventive measure was tested in a controlled environment. The UDF mobile units allows for a " corridor" of laminar flow over a designated area, either an instrument table or a surgical area. The UDF mobile unit may enhance operating theatres were air quality is a problem due to old constructive problems or size and age of the building. The purpose of this study was to determine the degree of protection derived from using mobile unidirectional flow (UDF) units in a controlled environment in a simulated cataract surgery procedure.
Setting:
Private refractive surgery clinic, Driebergen, the Netherlands.
Methods:
In a controlled environment of a class7 ((ISO 14644-1, Cleanrooms and associated controlled environments, part 1: Classification of air cleanliness)) 2 UDF units were set up as in a cataract surgery. One unit covered the instrumentation table and the other the operative field. The background and instrument table and operative field particle count was repeatedly measured and compared at rest and during the sham procedure. The degree of protection for particles between 0.3 and 1.0 microns was measured and analyzed in the designated area by taking the logarithm of the ratio of background and operational counts of particles.
Results:
At rest the UDF units provided a degree of protection of 5.0 at the instrument table, for particles sized 0.3, 0.5, and 1.0 microns. At the periocular area the degree of protection at rest was 5.0 for 1.0 micron particles, 4.76 (3.98 to 5.53, 95% Confidence Interval [CI]) for particles of 0.5 microns, and 4.72 (2.98 to 6.46, 95% CI) for particles of 0.3 microns. Operationally at the instrument table the degree of protection varied from 4.47 to 5.20 for the different sized particles. At the periocular surgical area the degree of protection was 2.2 (1.91-2.250, 95% CI) for 1 micron particles, 2.72 (2.55-2.89, 95% CI) for 0.5 microns particles, and 2.83 (2.69-2.97, 95% CI) for 0.3 micron particles.
Conclusions:
UDF mobile units can confer a degree of protection during cataract surgery. The degree of protection at the instrument table was between: 4.47 to 5.2 depending on different particle sizes. The degree of protection at the periocular area was between 2.20 and 2.83 for particles between 0.3 and 1.0 microns. At the instrument table and at the operative site unidirectional flow can confer a degree of protection that may decrease bacterial contamination. FINANCIAL DISCLOSURE?: ... receives consulting fees, retainer, or contract payments from a competing company, ... research is funded, fully or partially, by a competing company, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented
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