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Systematic Reviews
Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Research

Effectiveness of architectural separation of septic and aseptic operating theatres for improving process quality and patient outcomes: a systematic review

Authors: Romy Scholz, Alexander Hönning, Julia Seifert, Nikolai Spranger, Dirk Stengel

Published in: Systematic Reviews | Issue 1/2019

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Abstract

Background

Architectural division of aseptic and septic operating theatres is a distinct structural feature of surgical departments in Germany. Internationally, hygienists and microbiologists mainly recommend functional separation (i.e. aseptic procedures first) without calling for separate operating floors and rooms. However, patients with severe musculoskeletal infections (e.g. joint empyema, spondylodiscitis, deep implant-associated infections) may benefit from the permanent availability of septic operating capacities without delay caused by an ongoing aseptic surgical program. A systematic literature review on the influence of a structural separation of septic and aseptic operating theatres on process and/or outcome quality has not yet been conducted.

Methods

Systematic literature search in PubMed MEDLINE, Ovid Embase, CINAHL and the Cochrane Library, screening of referenced citations, and assessment of grey literature.

Results

A total of 572 articles were found through the systematic literature search. No head-to-head studies (neither randomised, quasi-randomised nor observational) were identified which examined the impact of structural separation of septic and aseptic operating theatres on process and/or outcome quality.

Conclusions

This review did not identify evidence in favour nor against architectural separation of septic or aseptic operating theatre. Specifically, there is no evidence of a harmful effect of architectural separation. Unless prospective studies, ideally randomised trials, will be available, it is unjustified to call for abolishing established hospital structures. Future investigations must address patient-centered endpoints, surgical site infections, process quality and hospital economy.

Systematic review registration

PROSPERO (International prospective register of systematic reviews): CRD42018086568.
Appendix
Available only for authorised users
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Metadata
Title
Effectiveness of architectural separation of septic and aseptic operating theatres for improving process quality and patient outcomes: a systematic review
Authors
Romy Scholz
Alexander Hönning
Julia Seifert
Nikolai Spranger
Dirk Stengel
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0937-9

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