Comparison of generation of particles and bacteria in endoscopic surgery and thoracotomy
Comparison of generation of particles and bacteria in endoscopic surgery and thoracotomy
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DOI：
10.1016/j.buildenv.2021.107664
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发表时间：
2021-04
影响因子：
7.4
通讯作者：
Akane Odagiri;U. Yanagi;S. Kato
中科院分区：
文献类型：
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作者：
Akane Odagiri;U. Yanagi;S. Kato
保持手术室的空气质量对于预防手术部位感染非常重要。手术烟雾是细菌或病毒引起的感染的危险因素。在这项研究中，进行了原位测量，以了解同一手术室内窥镜手术和开胸手术期间产生的颗粒物的粒径、活细菌和微生物组的特征。在开胸手术期间，观察到空气颗粒物浓度急剧上升（≥0.3μm、≥0.5μm和≥0.5μm） 开始使用电外科工具时直径≥1.0μm）。此外，开胸手术期间空气中颗粒的浓度高于内窥镜手术期间的空气颗粒浓度。此外，内窥镜手术和开胸手术期间空气中颗粒的平均值显着超过 ISO 14644-1 标准。开胸手术期间接触空气颗粒的水平比内窥镜手术高出 4-27 倍。在内窥镜手术期间，手术台附近和进气口处的细菌浓度分别为 56 CFU/m3 和未检测到。相比之下，开胸手术过程中，手术台附近和进气口处的空气传播浓度分别为533 CFU/m3和11 CFU/m3，表明开胸手术过程中产生的细菌比内镜手术过程中产生的细菌更多。根据16S rRNA分析，每个样本的前四个属，即链球菌属、不动杆菌属、奈瑟氏菌属和葡萄球菌属，均为人类来源的细菌。
Maintaining air quality in operating rooms is import to prevent surgical site infections. Surgical smoke is a risk factor for infections that can be caused by bacteria or viruses. In this study, in situ measurements were conducted to understand the characteristics of airborne particles based on particle size, viable bacteria, and microbiome generated during an endoscopic surgery and a thoracotomy performed in the same operating room on a single day.During thoracotomy, a sharp rise was observed in the concentration of airborne particles (≥0.3 μm, ≥0.5 μm, and ≥1.0 μm in diameter) at the beginning of the use of electrosurgical tools. Furthermore, the concentration of airborne particles was higher during thoracotomy than during endoscopic surgery. Additionally, the mean values of airborne particles during both endoscopic surgery and thoracotomy significantly exceeded the ISO 14644-1 standard. The level of exposure to airborne particles during thoracotomy was found to be 4–27 times higher than that during endoscopic surgery.During endoscopic surgery, the concentration of bacteria near the operating table and at the air inlet was 56 CFU/m3and undetected, respectively. In comparison, during thoracotomy, the concentration of airborne near the operating table and at the air inlet was 533 CFU/m3and 11 CFU/m3, respectively, indicating that more bacteria were generated during thoracotomy than during endoscopic surgery. Based on 16S rRNA analysis, the top four genera of each sample, that is,Streptococcus,Acinetobacter,Neisseria, andStaphylococcus,were bacteria of human origin.