RESEARCH AND PUBLICATIONS
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Contamination Control in Oprating Theatres
Keywords: Patient Safety, Contamination Control, Performance of ventilation systems
Patient safety is a main topic during surgery. One of the main issues inside operating theatres (OR’s) is the prevention of airborne particles with bacteria that contaminate the wound area and the instruments. The risks and requirements differ for different types of surgery. To minimize the contaminations and improve the patient safety, controlling the quality of the air inside an OR is essential. Several type of air handling systems are available, suitable for different types of surgery. The most used systems are:
The number of colony forming unit is the environment around the patient has an effect on the surgical site infections. When the environment in the OR is clean, the risk of infection will decrease. What is the best ventilation system in an OR in relation to the requirements of surgery, airborne particles and the use of antibiotic prophylaxis? This paper will provide a comparison of different ventilation systems that will support hospital staff to make decisions about the quality of their Operating Theatres. The three systems will be compared both “at rest” and “in operation”.
Future Proof Operating Theatres
Keywords: Risk's, Ventilation Systems, Future, Patient Safety
Contamination Control in hospitals will increase because of all risks for the patient. Risk control is important in all departments where patients, medicine and medical devices are treated. Contamination Control will increase in the departments:
The risk for a patient comes form different sources. Most contamination is caused by contact. The contact with human bodies, instruments, equipment and medicine is a possible threat. Other contamination will come via the air. When air is polluted with bacteria contamination can occur.
An major risks is the resistance against anti biotic. More people become resistive against antibiotics and cure methods have to be changed. Also the circumstances for cure processes need to be changed. To reduce the risk for contamination the need for antibiotics will decrease.
To become more independent of antibiotics is something for the future. There are already bacteria which can’t be treated with antibiotics. For example the Staphylococcus epidermidis is a bacteria which is resistive against all known antibiotics. This bacteria is already spreading in some parts of the world. In Europe there are no cases known whit this bacteria at this moment.
Sustainability and patient safety in OR's
Keywords: Patient Safety, Contamination Control, Ventilation system, Energy Savings, Sustainability
Sustainability is an important topic for hospitals because in the Netherlands all hospitals together, are responsible for 7% of the CO2 footprint. With different methods and goals every hospital is trying to reduce this footprint. Inside a hospital the OR department is responsible for a large proportion of this CO2 footprint as it is using a lot of energy to create a safe environment for surgery. However patient safety is remains the most important aspect inside an OR. Contamination Control in an OR is necessary for patient safety.
When the environment in an OR is clean, the risk of infection will decrease. The environment surrounding the patient has an effect on the level of surgical site infections (SSI) This assumption is based on the fact that the higher the number of airborne bacteria, (CFU) the higher the risk of a SSI.. What is the best ventilation system in an OR in relation to the requirements of surgery, airborne particles and use of antibiotic prophylaxis with a minimum use of energy?
Airborne contamination will be removed with a controlled ventilation system. For the ventilation in an OR different systems are available. For an OR with an UDF system the most common solution is a LAF plenum in the middle of the OR. A LAF system function with an amount of air which depend on the size of the plenum. When a plenum of 3,2 m x 3,2 m is used, an amount of 11,000 m3/h of air is needed with an air speed of 0.3 m/s in the surgical area. The consequences of this amount of air is the use of a lot of energy to create a surgical area of 9 m2. To save energy the amount of air should be reduced with preservation of patient safety. Consequences will be a small sterile area for surgery and an increase of risks for of SSI.
With a Temperature Controlled Air Flow ventilation system the amount of air will be reduced and the contamination control stay the same or increase. To determine the effectiveness of this ventilation system measurements are done. We have done measurements with particles “At Rest” to get information about the OR itself. After acquiring the knowledge of the OR measurements were done during surgery. In an OR in Gothenburg measurements were done during 4 different types of surgery. Every type of surgery was simulated according a regular procedure without a patient. During the simulations particles and micro-organisms were measured.
This presentation will present the results of those measurement of particles and micro-organisms in the Temperature Controlled Air Flow ventilation systems “In Use”. Every type of surgery was an increase of 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 the Swedish and Dutch guidelines for classification of an OR.