Novel airflow ring for the reduction of germ load in a surgical field

Abstract

Hospital-acquired infections occur through microbial contamination of the surgical wound and can lead to severe complications. A significant transmission path is the aerogenic transmission, where pathogens stick to floating particles like skin scales or to air moisture. A novel porous airflow ring which is placed around the surgical field aims to overcome this by applying sterile air directly at the operation wound. The ring is provided with an air tight coating at the outer side and allows for fixation on the skin by an adhesive coating at the lower side. To evaluate its performance the airflow ring was placed in an atmosphere with nebulized suspension of Staphylococcus arlettae of a concentration of 5.0 x 10^5 CFU/ml resp. 5.0 x 10^6 CFU/ml within a box. The formation of bacterial colonies (CFU) on contact plates placed within the airflow ring was subsequently determined by visual counting after incubating at 37 °C for one day. CFU counts of the ventilated and the unventilated situation were compared. With the smaller inoculum, the introduction of bacteria into the inner site of the ring was completely prevented, whereas the contact plate of the unventilated ring resulted in 77 to 427 colonies in different trials. With the higher inoculum, the bacteria ingress was very strongly reduced by 99.7% respectively 99.9%. In conclusion the airflow ring shows a strong shielding effect for germs adhered to fog-sized water droplets. To clearly demonstrate the effect, the number of bacteria was greatly increased compared to reality in this setup. It was shown that it can withstand even conditions significantly worse than those encountered in an operating theatre. In order to demonstrate the effect in vivo, clinical trials have to be conducted to confirm the laboratory results.

Keywords

• nosocomial infections
• hospital infections
• sterile airflow
• surgical wounds