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World Journal of Surgery

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01-04-2021 | Escherichia Coli | Original Scientific Report

Higher Surgery and Recovery Room Air Pressures Associated with Reduced Surgical Site Infection Risk

Authors: Byron L. Crape, Arnur Gusmanov, Binur Orazumbekova, Karapet Davtyan

Published in: World Journal of Surgery | Issue 4/2021

Abstract

Background

Incisional surgical site infections (SSIs) following coronary artery bypass grafting (CABG) prolong hospital stays, elevate healthcare costs and increase likelihood of further complications. High air pressure deactivates bacteria and is utilized for commercial food preservation, assuring microbiologically safe pharmaceuticals and sanitizing instruments. However, research on utilizing air pressure deactivation thresholds in surgical and postoperative rooms to reduce rates of SSIs is lacking.

Methods

A case–control study of 801 CABG patients, 128 SSI cases and 673 controls was conducted from January 1, 2006 through March 31, 2009 in Yerevan, Armenia. Patient and surgery characteristics, air pressure measurements and seasons were selected as independent variables with SSI rates as the outcome. The novel threshold regression analysis was used to determine potential air pressure bacterial deactivation thresholds. A final multivariate logistic regression model adjusted for confounders.

Results

Overall, bacterial deactivation air pressure threshold was 694.2 mmHg, with the presence of infection for higher air pressure values not statistically significant from zero. Individual deactivation thresholds for Staphylococcus epidermidis (threshold = 694.2 mmHg) and Escherichia coli (threshold = 689.2) showed similar patterns. Multivariate logistic regression showed air pressure above the deactivation threshold was highly protective against SSIs with adjOR = 0.27 (p-value = 0.009, 95%CI: 0.10–0.72). Other SSI risk factors included female sex, adjOR = 2.12 (p-value = 0.006, 95%CI: 1.24–3.62), diabetes, adjOR = 2.61 (p-value < 0.001, 95%CI: 1.72–3.96) and longer time on ventilator, adjOdds = 1.01 (p-value = 0.012, 95%CI: 1.00–1.02).

Conclusion

Maintaining air pressures in operating and postoperative rooms exceeding bacterial-deactivation thresholds might substantially reduce SSI rates following surgery. Further research should identify specific bacterial-deactivation air pressure thresholds in surgical and postoperative rooms to reduce SSI rates, especially for drug-resistant bacteria.

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Title: Higher Surgery and Recovery Room Air Pressures Associated with Reduced Surgical Site Infection Risk
Authors: Byron L. Crape
Arnur Gusmanov
Binur Orazumbekova
Karapet Davtyan
Publication date: 01-04-2021
Publisher: Springer International Publishing
Keywords: Escherichia Coli
CABG
CABG
Published in: World Journal of Surgery / Issue 4/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05932-1

At a glance: The STEP trials

Springer Medicine

Higher Surgery and Recovery Room Air Pressures Associated with Reduced Surgical Site Infection Risk

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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