Laminar air flow in an operating room is carefully designed to prevent airborne contaminants from reaching the sterile field. However, even the most perfectly constructed ORs can’t fully prevent infectious particles from landing in surgical incisions. “The biggest infection risk in the room is the flora shed by patients and providers,” says Linda L. Dickey, RN, MPH, CIC, CPHQ, FAPIC, who owns her own healthcare consulting company.
She points to the potential benefits of filtering OR air or treating it with UV-C disinfection to eliminate the airborne contaminants that increase infection risks. The technology has been around for a while, but the pandemic — as well as some recent facility design guideline changes — has added a new urgency to the debate about whether surgical facilities should invest in systems that purify the air around the surgical table. Consider some of the more exciting air purification technologies on the market to decide for yourself:
• Overhead systems. Ceiling LED light units with integrated UV-C disinfection capabilities provide uninterrupted protection against airborne pathogens. Integrated fans draw air in through a vent at one end of the light unit and into the UV-C chamber, where it’s treated before being pushed out a vent at the opposite side of the unit. Unlike whole room UV-C disinfection systems that require ORs to be empty while they’re activated and rely on maintaining a direct line of site with the surfaces being treated, air purification systems can be used safely and continuously with staff in the room.
“The benefit is that UV-C air purification is one of most effective methods for killing contaminants,” says Mike Zorich, PE, LEED, AP, principal/director of healthcare at IMEG Corp, an enginering consulting firm. “That’s been proven.”
UV-C is one of the best sources for killing contaminants.
— Mike Zorich, PE, LEED, AP
• Portable units. These mobile devices, which employ HEPA filtration and UV-C disinfection, can be wheeled directly into an OR and strategically placed in a location near the sterile field where the unit takes in and treats contaminated air. HEPA filtration and UV-C light is certainly a powerful combination, but Mr. Zorich says there is one drawback facilities don’t often consider. “These units generate a lot of noise,” he says. “In a busy OR where staff are trying to communicate, that could become an issue.” He believes, however, that as the technology evolves, upgrades made to future models will remedy the noise issue.
• Increased air exchanges. While the bulk of air purification systems incorporate UV-C, HEPA filtration, or both, a developing technology aims to eliminate particulates within the sterile field simply by increasing the number of air exchanges. “These systems provide between 80 to 90 exchanges per hour directly over the patient to reduce particulate counts within the sterile field,” says Mr. Zorich.