ENVIRONMENTAL CLEANING Figure 2. Example of Between-Patient Cleaning: Operating and Procedure Rooms
MDRO, implement enhanced environmental cleaning procedures (see Recommendation 8.1). [Recommendation] The CDC and moderate-quality evidence sup-
port not performing terminal cleaning or closing the OR after surgery on a patient with an infected wound.14,97-99 In a retrospective controlled study in a large Canadian hospital, Abolghasemian et al98
evaluated
the incidence of HAIs in 83 patients who had an arthroplasty procedure in an OR in which the pre- vious patient had a known infection. The research- ers found that an infection was no more likely to occur in a patient whose surgery followed that of a patient with an infection than that of a patient without an infection. Of note, between-patient cleaning was completed using diluted 7% chlorhexi- dine solution, which is not an EPA-registered disin- fectant, and neither unilateral ultraclean air flow nor orthopedic surgical space suits were used.
Balkissoon et al14
conducted a prospective correla-
tional study at an academic medical center in the United States to evaluate microbial surface contamina- tion after standard between-patient cleaning following 14 surgeries on patients with infections and 16 surger- ies on patients without infections. The surgeries were open procedures in multiple surgical specialties. The researchers did not find significant differences in bac- terial contamination of high-touch surfaces in the OR between the two groups. The researchers concluded that standard between-patient cleaning reduced sur- face contamination to a minimum regardless of the infection status of the previous patient, and therefore the need for additional cleaning after a contaminated or dirty/infected procedure is not necessary. In an exploratory prospective observational study at a German university hospital, Harnoss et al99
eval-
uated the microbial room air concentration, as well as microbial sedimentation at 0.5 m and 1.5 m from the sterile field for 16 general surgeries on
