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. 2025 Jul 18;12(3):e70321.
doi: 10.1002/jeo2.70321. eCollection 2025 Jul.

Key factors influencing orthopaedic operating room contamination: Impact of human activity and Staphylococcus epidermidis prevalence

Nicolas C I Ion  1   2 , Sorin R Fleaca  1   2 , Bogdan-Axente Bocea  1   2 , Cosmin-Ioan Mohor  1   2 , Mihai-Dan Roman  1   2 , Alexandru-Florin Diconi  1   2 , Adrian N Cristian  1   2 , Doru-Florian-Cornel Moga  1   3 , Mona Y Cataniciu  1   3 , Ovidiu N Popa  1   3 , Adrian G Boicean  1   2 , Victoria Birlutiu  1   2
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Key factors influencing orthopaedic operating room contamination: Impact of human activity and Staphylococcus epidermidis prevalence

Nicolas C I Ion et al. J Exp Orthop. .

Abstract

Purpose: The presence of pathogen microorganisms in the operating room remains a significant concern. This study aims to explore the factors influencing the presence of pathogens in the operating room.

Methods: We analysed the presence of microorganisms in the operation theatre during total knee and hip replacement procedures for 33 patients performed in the same operation room (OR) over a period of 2 months. Three hundred and ninety-six samples were taken from several areas belonging to the sterile field. We have also analysed behavioural aspects in the OR that could influenced the potential contamination of the sterile field, such as the number of touches of the lamps, the temperature in the OR, the height of the operating table, the number of door openings.

Results: Out of the total of 396 samples, 74 were positive. Most contaminations were with Staphylococcus epidermidis (45.45%). Most pathogens were found on the instrument table at the end of the intervention (27.27%). There is a correlation regarding the fact that at lower heights, the risk of contamination higher than if the table is raised more. We also find correlations between the number of operating room doors opened and the presence of field contamination, as well as between the number of touches of the lamps and the presence of pathogens on sterile fields.

Conclusion: The presence of pathogens in the OR is influenced by the number of lamp touches, the frequency of door openings, and the increased number of people in the room. However, temperature and the height of the operating table do not have a significant impact on the occurrence of pathogens. The most commonly found pathogen in the OR was S. epidermidis. At the end of the surgery, the instrument table showed the highest percentage of pathogen presence.

Level of evidence: Level IV, case series.

Keywords: Staphylococcus; hip; knee; operating room; orthopaedic.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The correlation between new pathogens in the operating room and temperature at different operation stages.
Figure 2
Figure 2
The correlation between surgical table height during surgery and new pathogens at different operation stages.
Figure 3
Figure 3
The percentage of pathogens identified in the operating room during surgical interventions.
Figure 4
Figure 4
The correlation between door openings during surgery and new pathogens at 60 min and completion.
See this image and copyright information in PMC

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