Total and viable airborne particulates during orthopaedic surgical procedures

Prof. William Walsh1, Dr. Rema Oliver1, Professor Warwick Bruce1, Dr. Richard Verheul1

1University Of New South Wales, Randwick, Australia

Introduction: The prevention of post-operative wound infection is important. We surveyed the airborne particulate generated across a range of orthopaedic, spinal and plastic surgery procedures (Phase 1). We  examined viable particles using a real time laser-induced fluorescence (LIF) system and bacteria cultures during routine arthroplasty surgery with and without a novel air decontamination-recirculation system (ADRS) (Phase 2).

Method: Phase 1 evaluated airborne particulate with the LIF airborne particle counter during arthroplasty, sports medicine, plastic surgery and spinal cases of eight surgeons. Total and viable particles were measured in 2 minute intervals from before the patient entered until after their removal. Phase 2 considered two operating theatres with the same number and type of surgical procedures (total knee replacement or total hip replacement) performed in each. 26 agar plate cultures were taken over the course of the day to assess bacterial load with and without the ADRS. Total and viable particles were also measured over a 2-minute period for the duration of the study.

Results: In Phase 1 the amount, size and timing of airborne particles correlated well with traffic and the surgical activity. Particles of 0.3-1 micron were generated throughout the whole procedure while larger particles appeared to be related to increased room activity. In Phase 2 the ADRS reduced the total and viable airborne particulates as well a colony forming units (CFU) per cubic meter. The LIF viable particle counter correlated well with the bacteria cultures.

Conclusion: Total and viable particulates and CFU’s were reduced with the novel ADRS.


Professor & Director Surgical & Ortho Res Labs at UNSW.

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