Operating-Room Airflow Technology and Infection Prevention

➤ Operating-room (OR) heating, ventilation, and air-conditioning (HVAC) systems play an important role in the reduction of airborne bacterial colony-forming units. ➤ Laminar flow ventilation systems reduce OR bacterial counts, but their ability to lower surgical site infection (SSI) rates in joint replacement procedures is controversial. ➤ Airborne bacteria in the OR during surgery are primarily produced by the OR staff and circulate in the air on shed skin particles (squames). ➤ Airflow patterns in the OR are complex and may be affected by the layout and operational characteristics of the HVAC system, door-opening events, heat generated by surgical equipment, forced-air warmers, and the movement of equipment and personnel. ➤ Forced-air warmers generate excess heat and convection currents within the OR but have not conclusively been shown to increase SSI rates. They are considered safe for use by the Association of periOperative Registered Nurses and remain the gold standard for maintaining perioperative patient normothermia.