Infections in the operating room

Learn how to prevent costs and unnecessary suffering by protecting yourself, your patients and your staff from hospital-acquired infections.

surgeons who operate in the operating room

We know that medical professionals are under constant pressure to reduce costs while improving standards of care and preventing cross-contamination.

It is estimated that one in 20 patients will contract a post-operative wound infection (SSI) and the rate of staff exposure to patient blood during surgery is 10.4 per 100 procedures . Ensuring patient safety in the OR and protecting healthcare professionals from infections and bloodborne diseases is a top priority.

Medical professionals are often exposed to pathogens. Needlestick injuries, of which there are an estimated one million per year in Europe, expose them to the risk of bloodborne diseases, including hepatitis B, hepatitis C and HIV.

  • Surgical solutions
  • Infection prevention
  • Article
  • Expert opinion

The problem with postoperative wound infections

Postoperative wound infections make for expensive treatments and cause patients pain and trauma. A postoperative wound infection, for example, can lead to infection of deep tissue structures, which in turn requires the patient to stay longer in the hospital and occupies a bed that could have already been used for other patients. Precisely this can be prevented.

Postoperative wound infections are caused by microbial contamination of the surgical wound. Microorganisms enter the wound by one of the following routes:

  • Through the patient’s skin
  • About the surgeon and other workers in the operating room
  • Through the air
  • About contaminated surfaces or instruments used in surgery

Preventing postoperative wound infection is not so simple. For example, it is estimated that ca. one third of the population naturally carries the bacteria Staphylococcus aureus on their skin and in their nostrils . Some strains of these bacteria (e.g. B. methicillin-resistant Staphylococcus aureus bacteria, MRSA) are resistant to various antibiotics. Both staphylococci and enterococci can survive days to months after drying out on commonly used fabrics and plastics in hospitals .

Air is also a source of infection: people shed thousands of skin flakes every minute , each potentially carrying bacteria (80% of bacteria come from the air ).

Gloves used to protect against infection

When preventing infection and cross-contamination in the OR, air, patients, staff, equipment and surfaces must all be considered. We work with healthcare professionals to find the most effective ways to prevent infection and cross-contamination.

Operating Room Gloves

Single-use gloves

Operating room gloves help reduce the risk of infection for healthcare professionals and patients – and are one of many factors that help prevent contamination in the OR . However, if a glove is punctured by a needle, the protection is lost and the hole may not even be visible. If gloves are perforated, there is an increased risk of postoperative wound infection .

Glove powder is sometimes used to facilitate donning and doffing of surgical gloves. However, this may cause lower resistance to infection, contamination of the environment by bacteria, foreign body reaction, delayed wound healing, adhesions and granuloma formation . All of these potential outcomes can increase the risk of postoperative wound infection.

Double gloves with perforation indication:

Double gloves with perforation indication system – wearing undergloves and overgloves simultaneously – allow healthcare professionals to immediately detect glove perforations. So they can quickly change gloves and continue the procedure without compromising protection from cross-contamination .

In a study of gloves used during surgery, the rate of perforations during surgery was 90.2% in the subgroup with indication gloves compared to 23% and 36.0% in the subgroups with combination gloves (two normal gloves) and single gloves, respectively .

Double gloves have been shown to reduce the risk of injuries from needlesticks or other sharp objects and from exposure to bloodborne diseases. A 2014 Cochrane study found that double gloves reduce the risk of perforation of the inner glove by 71% compared to single gloves .

Leading authorities now recommend the use of double gloves during invasive surgeries:

  • Centers for Disease Control and Prevention (CDC)
  • National Association of Theatre Nurses (NATN)
  • Association of periOperative Registered Nurses (AORN)
  • American College of Surgeons (ACS)
  • Royal College of Surgeons of England
  • Australian College of Operating Room Nurses

Preventing infections with surgical gowns

We believe staff uniforms play a critical role in infection prevention – protecting patients from staff contamination and enabling clean air in the OR.

Reusable surgical gowns

Traditional cloth surgical gowns are cleaned and reused between surgeries. However, stains and wear can compromise protection – performance is affected by quality and number of cleanings.

Disposable polypropylene surgical gowns

Disposable surgical gowns are discarded after use, reducing the risk of infection. Polypropylene surgical garments, in particular, provide less air and wound bacteria contamination than conventional cotton T-shirts and pants .

Clean Air Suits

Ultra-clean air in the OR is achieved through a combination of laminar air flow, the number of door openings, the amount of people in the OR, and clean air suits. It is particularly important in orthopedic and pediatric procedures and implantations.

Clean Air Suits are specifically designed to reduce contamination from staff airborne microorganisms. They offer better protection than reusable cotton/polyester systems because they offer high resistance to bacterial penetration, even when simple ventilation is used in the OR .

To minimize the risk of infection, clean air suits should be used, even if laminar airflow is in use.

Preventing contamination from the patient’s skin

Surgical drapes and full body washings can prevent microorganisms from the patient’s skin from contaminating the surgical wound and causing postoperative wound infection.

OP covers

Surgical drapes prevent microorganisms from being transferred from the patient’s skin to the surgical wound during surgery. Impermeable materials serve as a barrier to infection and effective fluid control allows for a drier work area. The most effective covers have fewer components and are easy to use – reducing the risk of contamination.

Skin cleansing

Whole-body washing reduces the bacterial load on the skin, ultimately reducing the risk of postoperative wound infection. There are several options for skin cleansing:

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