Operating room
surgical site infection
arthroplasty procedures.



Background: The rate of surgical site infections (SSI) is strongly influenced by operating room quality, which is determined by the structural features of the facility and its systems and by the management and behaviour of healthcare workers.

The aim of the present study was to assess the microbial contamination in operating room during hip- and knee-replacement procedures, the behavior of operating room staff and the incidence of SSI through postdischarge surveillance.

Methods: Microbial contamination was evaluated by active and passive samplings at rest and in operating conditions. Organizational and behavioral characteristics were collected by observational assessment. The incidence of SSI was evaluated in 255 patients and the follow-up examinations were carried out at 30 and 365 days after the procedure.

Results: The mean value of the airborne and sedimenting microbial load was respectively 12.90 CFU/m3 and 0.02 CFU/cm2/h.

With regard to outcome, the infection rate proved to be 0.89%, associated with knee-replacement procedures. The microorganism responsible for this superficial infection was Staphylococcus aureus.

Conclusion: Clinical outcomes proved to be satisfactory explained by the microbial load (in both at-rest and operating conditions), the appropriate behavior of the staff, compliance with the guidelines on preoperative antibiotic prophylaxis, and efficient management of the ventilation system.




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