Correlation of airborne bacteria in the operating room with surgical wound contamination and surgical site infection: a systematic review
Josefin Seth Caous, Karin Svensson Malchau, Camilla Björn, Birgitta Lytsy, Peter Grant, Ola Rolfson, A. Erichsen
Abstract
BACKGROUND: The impact of operating room air quality on the risk of surgical site infection (SSI) is a topic of debate. This systematic review explores correlation between intra-operative air contamination during clean surgery and (i) wound contamination, and (ii) the incidence of SSI. METHODS: Medline, EMBASE and the Cochrane Library were searched for original articles that investigated correlation between intra-operative airborne bacteria and either intra-operative wound contamination or the incidence of SSI in clean surgery. Three reviewers screened retrieved articles independently for eligibility, using Rayyan, and assessed quality and risk of bias using the Integrated Quality Criteria for the Review of Multiple Study Designs methodology. A narrative synthesis of the heterogenous data was performed following the Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. RESULTS: Thirteen publications encompassing 11 studies (total 18,694 patients) were included. Eight studies focused on wound contamination, two of which showed significant correlation with intra-operative air contamination. Five studies examined the incidence of SSI, three of which showed significant correlation with air contamination and one of which showed significant correlation with the ventilation system. CONCLUSION: on wound contamination and the incidence of SSI.