FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2896652208> ?p ?o ?g. }

• W2896652208 endingPage "S104" @default.
• W2896652208 startingPage "S97" @default.
• W2896652208 abstract "Question 1: Does the number of individuals in the operating room affect the rate of SSI/PJI? If so, what strategies should be implemented to reduce traffic in the operating room? Recommendation: Yes. The number of individuals in the operating room (OR) and door openings (DO) during total joint arthroplasty (TJA) are correlated to the number of airborne particles in the OR. Elevated airborne particles in the OR can predispose to subsequent periprosthetic joint infections (PJIs). Therefore, operating room traffic should be kept to a minimum. Multiple strategies, outlined below, should be implemented to reduce traffic in the OR during orthopedic procedures. Level of Evidence: Moderate Delegate Vote: Agree: 98%, Disagree: 2%, Abstain: 0% (Unanimous, Strongest Consensus) Rationale: The number of persons and door openings (DOs) in the operating room (OR) have been reported to disrupt the airflow [1Pulido L. Ghanem E. Joshi A. Purtill J.J. Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors.Clin Orthop Relat Res. 2008; 466: 1710-1715https://doi.org/10.1007/s11999-008-0209-4Crossref PubMed Scopus (1012) Google Scholar, 2Babkin Y. Raveh D. Lifschitz M. Itzchaki M. Wiener-Well Y. Kopuit P. et al.Incidence and risk factors for surgical infection after total knee replacement.Scand J Infect Dis. 2007; 39: 890-895https://doi.org/10.1080/00365540701387056Crossref PubMed Scopus (61) Google Scholar, 3Teter J. Guajardo I. Al-Rammah T. Rosson G. Perl T.M. Manahan M. Assessment of operating room airflow using air particle counts and direct observation of door openings.Am J Infect Control. 2017; 45: 477-482https://doi.org/10.1016/j.ajic.2016.12.018Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar, 4Weiser M. Shemesh S. Chen D. Bronson M. Moucha C. The effect of door opening on positive pressure and airflow in operating rooms.J Am Acad Orthop Surg. 2018; 26: e105-e113https://doi.org/10.5435/JAAOS-D-16-00891Crossref PubMed Scopus (23) Google Scholar], and therefore affect the quality of air in the OR. No high-level evidence study exists, though, to directly link the OR traffic with the development of periprosthetic joint infections (PJIs). The multivariate nature of PJIs and its low incidence require an enormous study population to directly evaluate the influence of OR traffic on PJIs, which is technically difficult. There is no consensus on the best methods of monitoring air quality in the OR [5Scaltriti S. Cencetti S. Rovesti S. Marchesi I. Bargellini A. Borella P. Risk factors for particulate and microbial contamination of air in operating theatres.J Hosp Infect. 2007; 66: 320-326https://doi.org/10.1016/j.jhin.2007.05.019Abstract Full Text Full Text PDF PubMed Scopus (145) Google Scholar, 6Stocks G.W. Self S.D. Thompson B. Adame X.A. O’Connor D.P. Predicting bacterial populations based on airborne particulates: a study performed in nonlaminar flow operating rooms during joint arthroplasty surgery.Am J Infect Control. 2010; 38: 199-204https://doi.org/10.1016/j.ajic.2009.07.006Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar, 7Birgand G. Toupet G. Rukly S. Antoniotti G. Deschamps M.N. Lepelletier D. et al.Air contamination for predicting wound contamination in clean surgery: a large multicenter study.Am J Infect Control. 2015; 43: 516-521https://doi.org/10.1016/j.ajic.2015.01.026Abstract Full Text Full Text PDF PubMed Scopus (46) Google Scholar, 8Pada S. Perl T.M. Operating room myths: what is the evidence for common practices.Curr Opin Infect Dis. 2015; 28: 369-374https://doi.org/10.1097/QCO.0000000000000177Crossref PubMed Scopus (15) Google Scholar, 9Tham K.W. Zuraimi M.S. Size relationship between airborne viable bacteria and particles in a controlled indoor environment study.Indoor Air. 2005; 15: 48-57https://doi.org/10.1111/j.1600-0668.2005.00303.xCrossref PubMed Scopus (52) Google Scholar]. Although particle counting is less demanding, and more standardized than microbiological sampling, the information obtained is indirect. Furthermore, the air particle counts cannot accurately predict the microbial contamination of the OR air [[10]Cristina M.L. Spagnolo A.M. Sartini M. Panatto D. Gasparini R. Orlando P. et al.Can particulate air sampling predict microbial load in operating theatres for arthroplasty?.PLoS One. 2012; 7: e52809https://doi.org/10.1371/journal.pone.0052809Crossref PubMed Scopus (45) Google Scholar]. The number of personnel in the OR and number of DOs have been recognized as a major source of increased number of particles in the OR air [5Scaltriti S. Cencetti S. Rovesti S. Marchesi I. Bargellini A. Borella P. Risk factors for particulate and microbial contamination of air in operating theatres.J Hosp Infect. 2007; 66: 320-326https://doi.org/10.1016/j.jhin.2007.05.019Abstract Full Text Full Text PDF PubMed Scopus (145) Google Scholar, 11Tjade O.H. Gabor I. Evaluation of airborne operating room bacteria with a Biap slit sampler.J Hyg (Lond). 1980; 84: 37-40https://doi.org/10.1017/S0022172400026498Crossref PubMed Scopus (15) Google Scholar, 12Malinzak R.A. Ritter M A Postoperative wound infection: 35 years of experience.Orthopedics. 2006; 29: 797-798Crossref PubMed Scopus (9) Google Scholar]. Several observational studies have demonstrated a positive relationship between the number of individuals and DOs and the number of aerosolized particles in the OR [3Teter J. Guajardo I. Al-Rammah T. Rosson G. Perl T.M. Manahan M. Assessment of operating room airflow using air particle counts and direct observation of door openings.Am J Infect Control. 2017; 45: 477-482https://doi.org/10.1016/j.ajic.2016.12.018Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar, 11Tjade O.H. Gabor I. Evaluation of airborne operating room bacteria with a Biap slit sampler.J Hyg (Lond). 1980; 84: 37-40https://doi.org/10.1017/S0022172400026498Crossref PubMed Scopus (15) Google Scholar, 13Smith E.B. Raphael I.J. Maltenfort M.G. Honsawek S. Dolan K. Younkins E.A. The effect of laminar air flow and door openings on operating room contamination.J Arthroplasty. 2013; 28: 1482-1485https://doi.org/10.1016/j.arth.2013.06.012Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar, 14Andersson A.E. Bergh I. Karlsson J. Eriksson B.I. Nilsson K. Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery.Am J Infect Control. 2012; 40: 750-755https://doi.org/10.1016/j.ajic.2011.09.015Abstract Full Text Full Text PDF PubMed Scopus (185) Google Scholar]. Ritter et al [[15]Ritter M.A. Eitzen H. French M.L. Hart J.B. The operating room environment as affected by people and the surgical face mask.Clin Orthop Relat Res. 1975; 111: 147-150Crossref PubMed Scopus (111) Google Scholar] reported that the bacterial counts were 34-fold higher when 5 or more persons were present, compared to an empty OR. DO may lead to increased contamination rates by 2 mechanisms. First, DOs in the OR are linked to the number of staff in the OR during operations [[16]Hannsen A. Rand J. Evaluation and treatment of infection at the site of a total hip or knee arthroplasty.Instr Course Lect. 1999; 48: 111-122Google Scholar]. Second, DOs create turbulence between 2 spaces, and disrupt the positive laminar flow of the OR, which might subsequently lead to faster spread of airborne bacteria and particles to the surgical field [1Pulido L. Ghanem E. Joshi A. Purtill J.J. Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors.Clin Orthop Relat Res. 2008; 466: 1710-1715https://doi.org/10.1007/s11999-008-0209-4Crossref PubMed Scopus (1012) Google Scholar, 13Smith E.B. Raphael I.J. Maltenfort M.G. Honsawek S. Dolan K. Younkins E.A. The effect of laminar air flow and door openings on operating room contamination.J Arthroplasty. 2013; 28: 1482-1485https://doi.org/10.1016/j.arth.2013.06.012Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar, 17Parikh S.N. Grice S.S. Schnell B.M. Salisbury S.R. Operating room traffic: is there any role of monitoring it?.J Pediatr Orthop. 2010; 30: 617-623https://doi.org/10.1097/BPO.0b013e3181e4f3beCrossref PubMed Scopus (46) Google Scholar, 18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar]. Andersson et al [[14]Andersson A.E. Bergh I. Karlsson J. Eriksson B.I. Nilsson K. Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery.Am J Infect Control. 2012; 40: 750-755https://doi.org/10.1016/j.ajic.2011.09.015Abstract Full Text Full Text PDF PubMed Scopus (185) Google Scholar] showed a positive correlation between traffic flow rates and air bacterial counts in orthopedic procedures. They also identified a direct correlation between the number of people present in the OR and bacterial counts. Quraishi et al [[19]Quraishi Z. Blais F. Sottile W. Adler L. Movement of personnel and wound contamination.AORN J. 1983; 38: 146-147Crossref PubMed Scopus (23) Google Scholar] demonstrated a direct correlation between the activity level of OR personnel and bacterial fallout into the sterile field. Additionally, Lynch et al [[20]Lynch R.J. Englesbe M.J. Sturm L. Bitar A. Budhiraj K. Kolla S. et al.Measurement of foot traffic in the operating room: implications for infection control.Am J Med Qual. 2009; 24: 45-52https://doi.org/10.1177/1062860608326419Crossref PubMed Scopus (112) Google Scholar] showed an exponential relationship between the number of DOs and the number of personnel in the OR. In their series, an information request was the main reason for the majority of DOs. Several studies have evaluated the incidences and causes of DOs during elective total joint arthroplasties (TJAs) [8Pada S. Perl T.M. Operating room myths: what is the evidence for common practices.Curr Opin Infect Dis. 2015; 28: 369-374https://doi.org/10.1097/QCO.0000000000000177Crossref PubMed Scopus (15) Google Scholar, 18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar, 20Lynch R.J. Englesbe M.J. Sturm L. Bitar A. Budhiraj K. Kolla S. et al.Measurement of foot traffic in the operating room: implications for infection control.Am J Med Qual. 2009; 24: 45-52https://doi.org/10.1177/1062860608326419Crossref PubMed Scopus (112) Google Scholar, 21Bédard M. Pelletier-Roy R. Angers-Goulet M. Leblanc P.A. Pelet S. Traffic in the operating room during joint replacement is a multidisciplinary problem.Can J Surg. 2015; 58: 232-236https://doi.org/10.1503/cjs.011914Crossref PubMed Scopus (27) Google Scholar, 22Patel P. DiBartola A. Phieffer L. Scharsscmidt T. MayersonJL Glassman A. et al.Room traffic in orthopedic surgery: a prospective clinical observational study of time of day.J Patient Saf. 2017; https://doi.org/10.1097/PTS.0000000000000330Crossref Scopus (4) Google Scholar]. Rates of 0.19/min to 0.65/min DOs for primary, and 0.84/min for revision TJAs have been reported [3Teter J. Guajardo I. Al-Rammah T. Rosson G. Perl T.M. Manahan M. Assessment of operating room airflow using air particle counts and direct observation of door openings.Am J Infect Control. 2017; 45: 477-482https://doi.org/10.1016/j.ajic.2016.12.018Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar, 18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar, 20Lynch R.J. Englesbe M.J. Sturm L. Bitar A. Budhiraj K. Kolla S. et al.Measurement of foot traffic in the operating room: implications for infection control.Am J Med Qual. 2009; 24: 45-52https://doi.org/10.1177/1062860608326419Crossref PubMed Scopus (112) Google Scholar, 21Bédard M. Pelletier-Roy R. Angers-Goulet M. Leblanc P.A. Pelet S. Traffic in the operating room during joint replacement is a multidisciplinary problem.Can J Surg. 2015; 58: 232-236https://doi.org/10.1503/cjs.011914Crossref PubMed Scopus (27) Google Scholar]. The highest percentage of DOs occurs during the preincision [[18]Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar] or postincision periods [[10]Cristina M.L. Spagnolo A.M. Sartini M. Panatto D. Gasparini R. Orlando P. et al.Can particulate air sampling predict microbial load in operating theatres for arthroplasty?.PLoS One. 2012; 7: e52809https://doi.org/10.1371/journal.pone.0052809Crossref PubMed Scopus (45) Google Scholar]. The majority of the traffic constitutes the circulating nurses, followed by surgical implant representatives, and then the anesthesia and orthopedic staff [18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar, 20Lynch R.J. Englesbe M.J. Sturm L. Bitar A. Budhiraj K. Kolla S. et al.Measurement of foot traffic in the operating room: implications for infection control.Am J Med Qual. 2009; 24: 45-52https://doi.org/10.1177/1062860608326419Crossref PubMed Scopus (112) Google Scholar, 21Bédard M. Pelletier-Roy R. Angers-Goulet M. Leblanc P.A. Pelet S. Traffic in the operating room during joint replacement is a multidisciplinary problem.Can J Surg. 2015; 58: 232-236https://doi.org/10.1503/cjs.011914Crossref PubMed Scopus (27) Google Scholar]. The most frequently reported single reason for DOs is getting supplies, along with gathering and transferring information. Scrubbing in and out during the procedure, staff rotation for breaks, talking with colleagues in the corridor, and coordinating with nursing and anesthesia personnel were also reported as reasons for DOs [18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar, 21Bédard M. Pelletier-Roy R. Angers-Goulet M. Leblanc P.A. Pelet S. Traffic in the operating room during joint replacement is a multidisciplinary problem.Can J Surg. 2015; 58: 232-236https://doi.org/10.1503/cjs.011914Crossref PubMed Scopus (27) Google Scholar]. It is important to note that the rate of unjustified traffic was considerably high among different studies [8Pada S. Perl T.M. Operating room myths: what is the evidence for common practices.Curr Opin Infect Dis. 2015; 28: 369-374https://doi.org/10.1097/QCO.0000000000000177Crossref PubMed Scopus (15) Google Scholar, 18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar]. Experimental, observational, and simulation studies have evaluated the influence of OR traffic on the OR environment [4Weiser M. Shemesh S. Chen D. Bronson M. Moucha C. The effect of door opening on positive pressure and airflow in operating rooms.J Am Acad Orthop Surg. 2018; 26: e105-e113https://doi.org/10.5435/JAAOS-D-16-00891Crossref PubMed Scopus (23) Google Scholar, 13Smith E.B. Raphael I.J. Maltenfort M.G. Honsawek S. Dolan K. Younkins E.A. The effect of laminar air flow and door openings on operating room contamination.J Arthroplasty. 2013; 28: 1482-1485https://doi.org/10.1016/j.arth.2013.06.012Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar, 23Mears S.C. Blanding R. Belkoff S.M. Door opening affects operating room pressure during joint arthroplasty.Orthopedics. 2015; 38: e991-e994https://doi.org/10.3928/01477447-20151020-07Crossref PubMed Scopus (38) Google Scholar, 24Sadrizadeh S. Tammelin A. Ekolind P. Holmberg S. Influence of staff number and internal constellation on surgical site infection in an operating room.Particuology. 2014; 13: 42-51https://doi.org/10.1016/j.partic.2013.10.006Crossref Scopus (88) Google Scholar, 25Rezapoor M. Alvand A. Jacek E. Paziuk T. Maltenfort M.G. Parvizi J. Operating room traffic increases aerosolized particles and compromises the air quality: a simulated study.J Arthroplasty. 2017; 33: 851-855https://doi.org/10.1016/j.arth.2017.10.012Abstract Full Text Full Text PDF Scopus (37) Google Scholar, 26Hamilton W.G. Balkam C.B. Purcell R.L. Parks N.L. Holdsworth J.E. Operating room traffic in total joint arthroplasty: identifying patterns and training the team to keep the door shut.Am J Infect Control. 2018; 46: 633-636https://doi.org/10.1016/j.ajic.2017.12.019Abstract Full Text Full Text PDF Scopus (13) Google Scholar]. Mears et al [[23]Mears S.C. Blanding R. Belkoff S.M. Door opening affects operating room pressure during joint arthroplasty.Orthopedics. 2015; 38: e991-e994https://doi.org/10.3928/01477447-20151020-07Crossref PubMed Scopus (38) Google Scholar] identified that DOs in 77 of 191 TJAs overwhelmed the positive OR pressure, allowing airflow to reverse from the hallway into the OR. The loss of positive OR pressure was a transient phenomenon; however, the time needed for the recovery of pressurization was unknown. On the contrary, Weiser et al [[4]Weiser M. Shemesh S. Chen D. Bronson M. Moucha C. The effect of door opening on positive pressure and airflow in operating rooms.J Am Acad Orthop Surg. 2018; 26: e105-e113https://doi.org/10.5435/JAAOS-D-16-00891Crossref PubMed Scopus (23) Google Scholar] reported that positive pressure was not defeated during any single DO; however, they found that contaminated outside air entered the OR if 2 doors were simultaneously opened. In their study, OR pressure recovery took approximately 15 seconds following a DO. They supported that OR contamination was more likely attributable to the effects of the personnel who enter the OR, rather than as a primary cause of DOs. Furthermore, Rezapoor et al [[25]Rezapoor M. Alvand A. Jacek E. Paziuk T. Maltenfort M.G. Parvizi J. Operating room traffic increases aerosolized particles and compromises the air quality: a simulated study.J Arthroplasty. 2017; 33: 851-855https://doi.org/10.1016/j.arth.2017.10.012Abstract Full Text Full Text PDF Scopus (37) Google Scholar] demonstrated that the laminar airflow was protective against the negative influences of the number of people, and partially of DOs. Smith et al [[13]Smith E.B. Raphael I.J. Maltenfort M.G. Honsawek S. Dolan K. Younkins E.A. The effect of laminar air flow and door openings on operating room contamination.J Arthroplasty. 2013; 28: 1482-1485https://doi.org/10.1016/j.arth.2013.06.012Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar] also showed that bacteria colony forming units cultured on plates placed in sterile basins in the OR during the operation were significantly negatively associated with any DOs, and the function of laminar air flow. An increased trend of PJIs is associated with high OR traffic [2Babkin Y. Raveh D. Lifschitz M. Itzchaki M. Wiener-Well Y. Kopuit P. et al.Incidence and risk factors for surgical infection after total knee replacement.Scand J Infect Dis. 2007; 39: 890-895https://doi.org/10.1080/00365540701387056Crossref PubMed Scopus (61) Google Scholar, 11Tjade O.H. Gabor I. Evaluation of airborne operating room bacteria with a Biap slit sampler.J Hyg (Lond). 1980; 84: 37-40https://doi.org/10.1017/S0022172400026498Crossref PubMed Scopus (15) Google Scholar, 17Parikh S.N. Grice S.S. Schnell B.M. Salisbury S.R. Operating room traffic: is there any role of monitoring it?.J Pediatr Orthop. 2010; 30: 617-623https://doi.org/10.1097/BPO.0b013e3181e4f3beCrossref PubMed Scopus (46) Google Scholar, 27Pryor F. Messmer P.R. The effect of traffic patterns in the OR on surgical site infections.AORN J. 1998; 68: 649-660https://doi.org/10.1016/S0001-2092(06)62570-2Crossref PubMed Scopus (64) Google Scholar]. Pryor and Messmer [[27]Pryor F. Messmer P.R. The effect of traffic patterns in the OR on surgical site infections.AORN J. 1998; 68: 649-660https://doi.org/10.1016/S0001-2092(06)62570-2Crossref PubMed Scopus (64) Google Scholar] demonstrated a positive, but nonsignificant, correlation between the total number of people who enter the OR and infection rates. In a cohort of 2864 operated patients, the infection rate was 1.52% when fewer than 9 and 6.27% when more than 17 different people entered the OR. Cross-sectional observational studies evaluated the effects of measures to control OR traffic and the number of personnel as a preventative strategy in reducing PJIs [1Pulido L. Ghanem E. Joshi A. Purtill J.J. Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors.Clin Orthop Relat Res. 2008; 466: 1710-1715https://doi.org/10.1007/s11999-008-0209-4Crossref PubMed Scopus (1012) Google Scholar, 8Pada S. Perl T.M. Operating room myths: what is the evidence for common practices.Curr Opin Infect Dis. 2015; 28: 369-374https://doi.org/10.1097/QCO.0000000000000177Crossref PubMed Scopus (15) Google Scholar, 18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar, 28Knobben B.A.S. van Horn J.R. van der Mei H.C. Busscher H.J. Evaluation of measures to decrease intra-operative bacterial contamination in orthopaedic implant surgery.J Hosp Infect. 2006; 62: 174-180https://doi.org/10.1016/j.jhin.2005.08.007Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar]. Knobben et al [[28]Knobben B.A.S. van Horn J.R. van der Mei H.C. Busscher H.J. Evaluation of measures to decrease intra-operative bacterial contamination in orthopaedic implant surgery.J Hosp Infect. 2006; 62: 174-180https://doi.org/10.1016/j.jhin.2005.08.007Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar] observed that systemic and behavioral measures in the OR, including limiting unnecessary activity and individuals in the OR, can lead to a significant reduction in the incidence of prolonged wound discharges and superficial PJIs, as well as a nonsignificant decrease in the deep PJIs. It was, however, difficult to determine the influence of each measure on the final results. Numerous strategies have been proposed to reduce OR traffic and subsequent contamination of the OR environment. These include the following: (1) limitation of the number of persons who are present during orthopedic procedures; observers, residents, researchers, and external vendors should be kept to a minimum [3Teter J. Guajardo I. Al-Rammah T. Rosson G. Perl T.M. Manahan M. Assessment of operating room airflow using air particle counts and direct observation of door openings.Am J Infect Control. 2017; 45: 477-482https://doi.org/10.1016/j.ajic.2016.12.018Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar, 18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar]; (2) storage of the frequently used instruments in the OR; (3) proper education of OR personnel regarding the potential correlations between OR traffic and infections [4Weiser M. Shemesh S. Chen D. Bronson M. Moucha C. The effect of door opening on positive pressure and airflow in operating rooms.J Am Acad Orthop Surg. 2018; 26: e105-e113https://doi.org/10.5435/JAAOS-D-16-00891Crossref PubMed Scopus (23) Google Scholar, 13Smith E.B. Raphael I.J. Maltenfort M.G. Honsawek S. Dolan K. Younkins E.A. The effect of laminar air flow and door openings on operating room contamination.J Arthroplasty. 2013; 28: 1482-1485https://doi.org/10.1016/j.arth.2013.06.012Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar, 18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar, 20Lynch R.J. Englesbe M.J. Sturm L. Bitar A. Budhiraj K. Kolla S. et al.Measurement of foot traffic in the operating room: implications for infection control.Am J Med Qual. 2009; 24: 45-52https://doi.org/10.1177/1062860608326419Crossref PubMed Scopus (112) Google Scholar]; (4) careful preoperative planning and templating so as to have all necessary supplies and implants into the OR [18Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar, 26Hamilton W.G. Balkam C.B. Purcell R.L. Parks N.L. Holdsworth J.E. Operating room traffic in total joint arthroplasty: identifying patterns and training the team to keep the door shut.Am J Infect Control. 2018; 46: 633-636https://doi.org/10.1016/j.ajic.2017.12.019Abstract Full Text Full Text PDF Scopus (13) Google Scholar]; (5) reduction of the OR traffic using verbal interventions to the staff [[1]Pulido L. Ghanem E. Joshi A. Purtill J.J. Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors.Clin Orthop Relat Res. 2008; 466: 1710-1715https://doi.org/10.1007/s11999-008-0209-4Crossref PubMed Scopus (1012) Google Scholar]; (6) lockage of the external door immediately after the entry of the patient into the OR with entrance only through the inner doors [4Weiser M. Shemesh S. Chen D. Bronson M. Moucha C. The effect of door opening on positive pressure and airflow in operating rooms.J Am Acad Orthop Surg. 2018; 26: e105-e113https://doi.org/10.5435/JAAOS-D-16-00891Crossref PubMed Scopus (23) Google Scholar, 13Smith E.B. Raphael I.J. Maltenfort M.G. Honsawek S. Dolan K. Younkins E.A. The effect of laminar air flow and door openings on operating room contamination.J Arthroplasty. 2013; 28: 1482-1485https://doi.org/10.1016/j.arth.2013.06.012Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar, 21Bédard M. Pelletier-Roy R. Angers-Goulet M. Leblanc P.A. Pelet S. Traffic in the operating room during joint replacement is a multidisciplinary problem.Can J Surg. 2015; 58: 232-236https://doi.org/10.1503/cjs.011914Crossref PubMed Scopus (27) Google Scholar]; (7) minimization of the staff rotation during each TJA, ideally to zero [[21]Bédard M. Pelletier-Roy R. Angers-Goulet M. Leblanc P.A. Pelet S. Traffic in the operating room during joint replacement is a multidisciplinary problem.Can J Surg. 2015; 58: 232-236https://doi.org/10.1503/cjs.011914Crossref PubMed Scopus (27) Google Scholar]; (8) use of intercom for communication with the outer door [[3]Teter J. Guajardo I. Al-Rammah T. Rosson G. Perl T.M. Manahan M. Assessment of operating room airflow using air particle counts and direct observation of door openings.Am J Infect Control. 2017; 45: 477-482https://doi.org/10.1016/j.ajic.2016.12.018Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar]; (9) no DOs for social visits, clinical discussions, or anesthetic supplies for the next case; (10) use of a door alarm to decrease DOs [[29]Eskildsen S.M. Moskal P.T. Laux J. Del Gaizo D.J. The effect of a door alarm on operating room traffic during total joint arthroplasty.Orthopedics. 2017; 40: e1081-e1085https://doi.org/10.3928/01477447-20171020-03Crossref Scopus (9) Google Scholar]; (11) prohibition of staff to enter or leave the OR unnecessarily; and (12) opening the necessary equipment as close as possible to the time of incision, in order to reduce the exposure of the sterile instruments to the increased traffic [[18]Panahi P. Stroh M. Casper D.S. Parvizi J. Austin M.S. Operating room traffic is a major concern during total joint arthroplasty hip.Clin Orthop Relat Res. 2012; 470: 2690-2694https://doi.org/10.1007/s11999-012-2252-4Crossref PubMed Scopus (130) Google Scholar]. Question 2: Does the risk of SSI/PJI increase when the surgeon performing the arthroplasty procedure has an upper respiratory infection? Recommendation: It is unlikely that the risks of SSIs/PJIs are increased in patients undergoing orthopedic procedures when the surgeon or surgical team has an upper respiratory infection. Level of Evidence: Moderate Delegate Vote: Agree: 85%, Disagree: 8%, Abstain: 7% (Super Majority, Strong Consensus) Rationale: Reports of the transmission of hepatitis B virus, hepatitis C virus, and HIV from healthcare workers to patients during invasive procedures have raised the question of whether physicians infected with upper airways pathologies should perform invasive orthopedic procedures, such as joint arthroplasty [30Johnston B.L. MacDonald S. Lee S. LeBlanc J.C. Gross M. Schlech W.F. et al.Nosocomial hepatitis B associated with orthopedic surgery—Nova Scotia.Can Commun Dis Rep. 1992; 18: 89-90PubMed Google Scholar, 31Lot F. Seguier J.C. Fegueux S. Astagneau P. Simon P. Aggoune M. et al.Probable transmission of HIV from an orthopedic surgeon to a patient in France.Ann Intern Med. 1999; 130: 1-6Crossref PubMed Scopus (94) Google Scholar]. It has been previously suggested that surgeons affected by hepatitis B virus, hepatitis" @default.
• W2896652208 created "2018-10-26" @default.
• W2896652208 creator A5009082520 @default.
• W2896652208 creator A5009441349 @default.
• W2896652208 creator A5009607763 @default.
• W2896652208 creator A5009960569 @default.
• W2896652208 creator A5011045944 @default.
• W2896652208 creator A5019573977 @default.
• W2896652208 creator A5022199884 @default.
• W2896652208 creator A5026494059 @default.
• W2896652208 creator A5029661348 @default.
• W2896652208 creator A5034679006 @default.
• W2896652208 creator A5042064959 @default.
• W2896652208 creator A5046597830 @default.
• W2896652208 creator A5046824478 @default.
• W2896652208 creator A5048847734 @default.
• W2896652208 creator A5049534003 @default.
• W2896652208 creator A5049631316 @default.
• W2896652208 creator A5053432017 @default.
• W2896652208 creator A5056806336 @default.
• W2896652208 creator A5063613593 @default.
• W2896652208 creator A5067323509 @default.
• W2896652208 creator A5074496802 @default.
• W2896652208 creator A5075786525 @default.
• W2896652208 creator A5085810819 @default.
• W2896652208 creator A5088219295 @default.
• W2896652208 date "2019-02-01" @default.
• W2896652208 modified "2023-09-30" @default.
• W2896652208 title "General Assembly, Prevention, Operating Room - Personnel: Proceedings of International Consensus on Orthopedic Infections" @default.
• W2896652208 cites W1532327820 @default.
• W2896652208 cites W1546177291 @default.
• W2896652208 cites W1554479009 @default.
• W2896652208 cites W1573387891 @default.
• W2896652208 cites W1847869089 @default.
• W2896652208 cites W1945274015 @default.
• W2896652208 cites W1973344071 @default.
• W2896652208 cites W1977806174 @default.
• W2896652208 cites W1982850520 @default.
• W2896652208 cites W1986139764 @default.
• W2896652208 cites W1989290209 @default.
• W2896652208 cites W1989865594 @default.
• W2896652208 cites W1993988765 @default.
• W2896652208 cites W1995533152 @default.
• W2896652208 cites W1996853541 @default.
• W2896652208 cites W1997998296 @default.
• W2896652208 cites W1998740091 @default.
• W2896652208 cites W2004820676 @default.
• W2896652208 cites W2005177170 @default.
• W2896652208 cites W2005281744 @default.
• W2896652208 cites W2007298920 @default.
• W2896652208 cites W2007564049 @default.
• W2896652208 cites W2013837320 @default.
• W2896652208 cites W2016579435 @default.
• W2896652208 cites W2023364498 @default.
• W2896652208 cites W2025212693 @default.
• W2896652208 cites W2026332389 @default.
• W2896652208 cites W2027972815 @default.
• W2896652208 cites W2028325840 @default.
• W2896652208 cites W2028379074 @default.
• W2896652208 cites W2037062280 @default.
• W2896652208 cites W2038062067 @default.
• W2896652208 cites W2039665478 @default.
• W2896652208 cites W2045980768 @default.
• W2896652208 cites W2050772773 @default.
• W2896652208 cites W2051610450 @default.
• W2896652208 cites W2054259413 @default.
• W2896652208 cites W2056260467 @default.
• W2896652208 cites W2056848913 @default.
• W2896652208 cites W2058141893 @default.
• W2896652208 cites W2062790269 @default.
• W2896652208 cites W2067037458 @default.
• W2896652208 cites W2068514610 @default.
• W2896652208 cites W2076067303 @default.
• W2896652208 cites W2083938951 @default.
• W2896652208 cites W2087420725 @default.
• W2896652208 cites W2087739643 @default.
• W2896652208 cites W2091315212 @default.
• W2896652208 cites W2094432941 @default.
• W2896652208 cites W2108693332 @default.
• W2896652208 cites W2112177094 @default.
• W2896652208 cites W2115775582 @default.
• W2896652208 cites W2122631447 @default.
• W2896652208 cites W2125251960 @default.
• W2896652208 cites W2131428092 @default.
• W2896652208 cites W2131668560 @default.
• W2896652208 cites W2134759176 @default.
• W2896652208 cites W2138453842 @default.
• W2896652208 cites W2139580016 @default.
• W2896652208 cites W2143150404 @default.
• W2896652208 cites W2145348144 @default.
• W2896652208 cites W2147277552 @default.
• W2896652208 cites W2148933748 @default.
• W2896652208 cites W2152919367 @default.
• W2896652208 cites W2167535743 @default.
• W2896652208 cites W2168843978 @default.
• W2896652208 cites W2262623562 @default.
• W2896652208 cites W2270326546 @default.
• W2896652208 cites W2290346473 @default.

• next