Disinfecting surgical suites is hardly foolproof. We clean the rooms with traditional cleaning methods, but there are always surfaces that we overlook, as well as nooks and crannies that are hard to reach. That's why whole-room disinfection systems have a practical appeal.

The science behind these systems includes ultraviolet light, aerosolized or vaporized hydrogen peroxide, cluster ions and ozone gas, and the number of available products is on the rise. There's substantial evidence that these no-touch disinfection units can effectively decrease microbial growth in an environment, but the clinical literature hasn't yet definitively determined how much of an impact that might have on a facility's surgical site infection rates.

On the other hand, they can be seen as a valuable adjunct to manual cleaning in ambulatory surgical facilities. Given the expansion of the outpatient case mix, these automated systems provide an extra measure of protection. Since outpatient surgical suites aren't running 24-7, the systems are ideal additions to terminal cleaning practices at the end of the day's schedule.

If you're considering implementing whole-room disinfection at your facility, keep in mind that each method has its own advantages and differences in how it operates as well as in its effectiveness against specific pathogens. For example, ultraviolet light devices are easy to use and target a wide range of microorganisms. One potential drawback of UV light disinfection is that, as with any light, the equipment and furniture and other things in a room might cast shadows on other surfaces, preventing the light from disinfecting them. That's why a number of UV systems have to be repositioned in mid-process to complete the job. Hydrogen peroxide, on the other hand, is dispersed as a vapor or aerosol. It spreads around the room unblocked by obstacles, and there are no shadows. However, you must seal a room's ductwork before use, which can be time-consuming.

These factors, along with a review of the spaces and situations in which you intend to use whole-room disinfection, a system's cycle time, which personnel — clinical staff or environmental services? — will be trained to operate the devices, and the equipment's initial and continuing costs, will offer the best insight into which whole-room disinfection technology would be most effective for your facility.

Altapure
HJ-30i
altapure.com
(574) 485-2145
Pricing: $75,000
FYI: This no-touch, residue-free disinfection system deploys a dense cloud of aerosolized, sub-micron droplets to high-level disinfect all exposed surfaces. The system's preferred agent, the Altacare cold sterilant, is a powerful, broad-spectrum disinfectant consisting of 0.88% hydrogen peroxide, 0.18% peracetic acid and 98.58% ultra-pure water. The process can deliver room turnovers in less than 1 hour, start to finish, leaving surfaces clinically proven to show no growth for bacterial spores, vegetative bacteria and viruses.

American Ultraviolet
Operating Room Package
americanultraviolet.com
(908) 684-3290
Pricing: $35,000 to $50,000
FYI: These UV decontamination lamps are inexpensive to install and maintain, says the company. Ceiling-mounted, direct-style ultraviolet fixtures bathe the OR space and its contents in UVC energy. Wall-mounted, indirect-style fixtures create a high-intensity beam of energy above the surgical table. Above-door-mounted, barrier-style fixtures create a curtain of UV energy. A user-friendly interface features data logging, multiple cycle options and real-time system diagnostics. The package also includes on-site and in-service training, a radiometer, hardware and engineering design assistance. When used as part of the terminal cleaning protocol, American Ultraviolet's Operating Room Package has a typical disinfection cycle time of 5 to 10 minutes.

Bioquell
Q-10
bioquell.com
(215) 682-0225
Pricing: $53,000 to $58,000
FYI: Bioquell's Q-10 system evenly distributes hydrogen peroxide vapor throughout the treated space to kill 99.9999% of the pathogens, through a repeatable, verifiable process that uses an EPA-registered sterilant that is residue-free and compatible with sensitive electronics. Hydrogen peroxide vapor's effects have been examined in more than 40 peer-reviewed studies and, in recent months, the process has been used around the world to decontaminate the rooms and ambulances involved in the treatment of Ebola patients.

Sanosil International
Halo Disinfection System
sanosilinternational.com
(877) 726-6745
Pricing: Full system with accessories: less than $8,000. Operationally, less than $15 on average per completely disinfected patient room.
FYI: The compact, portable HaloFogger dispenses an aerosolized, dry-mist disinfectant to treat all of the surfaces in a room, including those in crevices and corners, without the manual labor of sprays and wipes. The system, which compares favorably in cost, performance and ease of use to UV and HPV options, offers a choice of 5% hydrogen-peroxide-based, healthcare-grade solutions: HaloMist Fogging Solution, proven to kill 99.9999% of C. diff spores; and HaloSpray All-Purpose Surface Disinfectant, effective against a range of pathogens and fungi. Both are odorless and safe for use around sensitive electronic equipment, says the company.

Steris
Pathogon UV Disinfection System
steris.com
(800) 548-4873
Pricing: not disclosed
FYI: Designed for use following manual terminal cleaning, Steris's easy-to-use, lightweight, maneuverable system automatically delivers a calculated dose of germicidal UVC energy to reduce or kill aggressive pathogens and disinfect clean, dry surfaces in less than 30 minutes. The system doesn't produce ozone or secondary contaminants, so rooms can be reoccupied immediately after the treatment is finished.

Surfacide
Helios UV-C Disinfection System
surfacide.com
(844) 390-3538
Pricing: $127,500
FYI: This system's 3 mobile towers deliver ultraviolet energy to all of a room's high-touch surfaces in a single disinfection cycle, letting you treat a larger space at one time. This solves the problem of shadowed and untreated areas, and eliminates the need to reposition a single emitter multiple times to ensure complete disinfection. The triple-emitter Helios system can treat an entire space in less than 30 minutes. A proprietary laser room-mapping technology ensures the uniform delivery of energy and enables validation that it has reached every surface. The system can detect entries into rooms in which it is operating and, as a response, shut down all 3 towers instantly for safety.

Tru-D
Smart UVC Room Disinfection
tru-d.com
(800) 774-5799
Pricing: not disclosed
FYI: The portable, remote-controlled, automated device operates from a single, central location in the room following manual cleaning, without requiring the input of room measurements, without covering windows or vents, and without repositioning the device to achieve a complete treatment. Eight calibrated sensors and a 360-degree scan of a room's size, geometry, surface reflectivity and contents calculate and deliver a timed dose of UV light disinfection. Cloud-based usage tracking software, accessible through the system's tablet computer remote control, uploads disinfection data so you can access reports in real time.

UVO3
Infection Fighter 31 Ultra
infectionfighter.com
(443) 406-2400
Pricing: $79,999
FYI: Delivers triple-action disinfection in one treatment to reduce and control pathogens on hard surfaces, soft furnishings and in the air for a complete, chemical-free room decontamination. Combines the application of ozone as a disinfectant (rendered through catalytic technology) with ultra-HEPA air microfiltration (which can capture and trap 99% of infectious airborne pathogens up to 0.3 micron in size) as well as the germicidal benefits of UV light, including an irradiation exposure chamber that can achieve a 100% pathogen kill rate during the air filtration process.

Xenex Disinfection Services
Germ-Zapping Robots
xenex.com
(800) 553-0069
Pricing: starts at $100,000
FYI: The "germ-zapping robot" can disinfect a typical patient or procedure room in 5 to 10 minutes. Works by pulsing xenon, an inert gas, at high intensity in a flash lamp. This produces broad-spectrum ultraviolet C (UVC), which quickly destroys infectious microorganisms, including C. diff, MRSA and VRE. Comes equipped with an easy-to-use, cloud-based reporting portal to track where the equipment has been operated, when the disinfection took place and who put it to work.

XStream Infection Control
XStream 2000
xstreamic.com
(877) 764-0003
Pricing: not disclosed
FYI: The XStream 2000 delivers a germicidal mix of pure cluster ions, which actively seek out pathogens via their electromagnetic charge and destroy them from the inside out, a process that requires no change in existing room-cleaning protocols. Fights germs on surfaces, carriers and in the air 24 hours a day, 7 days a week, without toxic cleaning solutions, ozone, H2O2, UV light, volatile organic compounds or copper-coated surfaces.