Infection prevention
Tackling the invisible threat in theatres
Surgical site infections continue to present issues for healthcare providers across the globe – despite the implementation of evidence-based care bundles. In this article, J. Hudson Garrett Jr. discusses how advanced air quality technology has the capability to transform the fight against healthcare-associated infections.
Surgical site infections represent a persistent and high-impact category of healthcare- associated infection (HCAI), affecting an estimated 2–5% of patients undergoing inpatient surgical procedures in the United States and accounting for approximately 20% of all HCAIs.1 The U.S. Centers for Disease Control and Prevention (CDC) estimates that SSIs result in more than one million additional hospital days annually and impose direct costs exceeding $3.5 billion per year.2
Beyond their economic
implications, SSIs are associated with increased 30-day mortality, a markedly elevated risk of re-admission, and diminished patient-reported outcomes across multiple surgical specialties.3 Contemporary prevention strategies have
been operationalised through evidence-based bundles that typically include appropriate timing and selection of prophylactic antibiotics, chlorhexidine-based skin antisepsis, maintenance of perioperative normothermia, and rigorous sterile technique.4
These
interventions address recognised SSI risk pathways, yet residual infection rates persist across institutions, suggesting that additional vectors of contamination warrant systematic attention.
Among these underappreciated vectors is the intraoperative airborne environment. The operating room is a uniquely dynamic space in which human occupants, physical activities, and mechanical air exchange interact
SSIs are associated with increased 30-day mortality, a markedly elevated risk of readmission, and diminished patient-reported outcomes across multiple surgical specialties.
continuously to generate and redistribute bioaerosols capable of direct wound inoculation. This review examines the scientific basis for airborne transmission of SSI pathogens, quantifies the contribution of intraoperative particle burden, and discusses the clinical rationale and evidentiary support for integrating continuous air decontamination technology into perioperative infection prevention programmes.
The microbiology and biophysics of intraoperative airborne contamination The human body is the dominant source of microbial contamination in the surgical environment. Each individual sheds approximately 10,000 to 60,000 skin squames per minute during ordinary activity, with vigorous movement substantially increasing dispersion rates.5
These desquamated epithelial
cells are frequently colonised by Staphylococcus aureus, coagulase-negative staphylococci, Streptococcus pyogenes, and gram-negative
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