Research & Publications

Our concepts are based on new technologies and innovations. Validation and research are key values in developing new concepts with proven technology. To create new concepts, we collaborate on several studies and conduct our own research to validate the effectiveness of our solutions. If you are interested in an article, please send an email to info@maximuse.one.

Automatic disinfection with UV-C in OR's

Keywords: UV-C disinfection, Operating Room, Disinfection robots

Micro-organisms such as bacteria, fungi, viruses, etc., pose a significant risk to patients. These micro-organisms can cause (deep wound) infections in patients after surgery. The aim of this research is to assess the effectiveness of (automatic) UV-C disinfection on different bacteria and materials.

Automatic disinfection with UV-C light is an effective technique for disinfecting a controlled environment. UV-C disinfection operates with a wavelength of 253.7 nm, which is not visible to the human eye. Several studies have shown that UV-C light is effective for disinfecting surfaces. All studies demonstrated its effectiveness when a surface is exposed to UV-C light with a wavelength of 253.7 nm. When UV-C disinfection machines are operated manually, the same risks are present as with manual disinfection. A robot equipped with UV-C lights could automatically disinfect every spot and surface in a controlled environment.

This research focuses on the effectiveness of automatic UV-C disinfection on different materials. A robot was used for the measurements, and the tests were conducted with two different wall materials. The results of the measurements aim to determine a level of disinfection. This means reducing micro-organisms to an acceptable level by either killing or inactivating the organisms. For disinfection, the reduction in the level of micro-organisms needs to be > 10⁵.

Future Proof Operating Theatres

Keywords: Risk's, Ventilation Systems, Future, Patient Safety

Contamination control in hospitals will become increasingly important due to the various risks posed to patients. Risk control is essential in all departments where patients, medications, and medical devices are handled. Contamination control will be particularly important in the following departments:

• Wards (isolation)
• Laboratories
• Pharmacy
• Central Sterilization and Storage Department (CSSD)
• ICU
• Radiology Department
• Preparation Rooms
• Operating Theatres (OR)

The risks to patients come from various sources. Most contamination is caused by contact, such as contact with human bodies, instruments, equipment, and medication. Airborne contamination is another concern; when air is polluted with bacteria, contamination can occur.

A major risk is antibiotic resistance. More people are becoming resistant to antibiotics, and treatment methods must be adapted. The conditions for treatment processes also need to change. To reduce the risk of contamination, the need for antibiotics must decrease.

Becoming more independent of antibiotics is a goal for the future. There are already bacteria that cannot be treated with antibiotics. For example, Staphylococcus epidermidis is a bacterium resistant to all known antibiotics. This bacterium is already spreading in some parts of the world. At present, no cases of this bacterium are known in Europe.

Sustainability and patient safety in OR's

Keywords: Patient Safety, Contamination Control, Ventilation system, Energy Savings, Sustainability

Sustainability is an important issue for hospitals, as in the Netherlands, all hospitals together are responsible for 6% of the CO2 footprint. Each hospital is working towards reducing this footprint through different methods and goals. Within a hospital, the Operating Room (OR) department is responsible for a large portion of this CO2 footprint due to the significant amount of energy required to create a safe environment for surgery. However, patient safety remains the most important aspect in an OR. Contamination control in the OR is essential to ensure patient safety.

When the environment in an OR is clean, the risk of Surgical Site Infections (SSI) decreases. The surrounding environment has an impact on the level of SSI. This assumption is based on the fact that the higher the number of airborne bacteria and colony-forming units (CFUs), the higher the risk of SSI. What is the best ventilation system in an OR that meets the requirements of surgery, airborne particles, and the use of antibiotic prophylaxis, while minimizing energy consumption?

Airborne contamination is removed by a controlled ventilation system. Several systems are available for OR ventilation. For an OR with an UDF system, the most common solution is a Laminar Air Flow (LAF) plenum located in the center of the OR. A LAF system operates with an air volume that depends on the size of the plenum. For a 3.2 m x 3.2 m plenum, approximately 11,000 m³/h of air is needed, with an airspeed of 0.3 m/s in the surgical area. The consequence of this air volume is a high energy consumption to create a surgical space of just 9 m². To save energy, the air volume should be reduced while maintaining patient safety. The consequence could be a smaller sterile area for surgery and an increased risk of SSI.

With a Temperature Controlled Air Flow (TcAF) ventilation system, the air volume can be reduced while maintaining or even increasing contamination control. To assess the effectiveness of this system, measurements were taken. We conducted "At Rest" particle measurements to gather information about the OR itself. After obtaining this baseline knowledge of the OR, additional measurements were made during surgery. In an OR in Gothenburg, Sweden, measurements were taken during four different types of surgery. Each type of surgery was simulated according to standard procedures, with medical staff and equipment, but without a patient. During these simulations, particles and micro-organisms were measured.

This paper presents the results of the particle and micro-organism measurements in the Temperature Controlled Air Flow ventilation systems "In Use." Each type of surgery involved an increase in equipment and medical staff inside the OR. All measurements were compared with each other, and the results of the "At Rest" measurements were compared with Swedish and Dutch guidelines for OR classification.

Contamination Control in Oprating Theatres

Keywords: Patient Safety, Contamination Control, Performance of ventilation systems

Patient safety is a key focus during surgery. One of the main concerns inside operating theatres (ORs) is the prevention of airborne particles containing bacteria that can contaminate the wound area and instruments. The risks and requirements vary depending on the type of surgery. To minimize contamination and improve patient safety, controlling the air quality inside an OR is essential. Several types of air handling systems are available, each suitable for different types of surgery. The most commonly used systems are:

• Turbulent Mixed Airflow Systems
• Laminar Airflow Systems
• Temperature Controlled Airflow Systems

The number of colony-forming units in the environment around the patient affects the risk of surgical site infections. When the environment in the OR is clean, the risk of infection decreases. What is the best ventilation system in an OR, considering the requirements of surgery, airborne particles, and the use of antibiotic prophylaxis? This paper will provide a comparison of different ventilation systems to assist hospital staff in making informed decisions about the quality of their operating theatres. The three systems will be compared both "at rest" and "in operation."