Infection Prevention and the Protective Effects of Unidirectional Displacement Flow Ventilation in the Turbulent Spaces of the Operating Room

Abstract

Background: Unidirectional displacement flow (UDF) ventilation systems in operating rooms are characterized by a uniformity of velocity ≥80% and protect patients and operating room personnel against exposure to hazardous substances. However, the air below the surgical lights and in the surrounding zone is turbulent, which impairs the ventilation system’s effect. Aim: We first used the recovery time (RT) as specified in International Organization for Standardization 14644 to determine the particle reduction capacity in the turbulent spaces of an operating room with a UDF system. Methods: The uniformity of velocity was analyzed by comfort-level probe grid measurements in the protected area below a hemispherical closed-shaped and a semi-open column-shaped surgical light (tilt angles: 0°/15°/30°) and in the surrounding zone of a research operating room. Thereafter, RTs were calculated. Results: At a supply air volume of 10,500 m3/h, the velocity, reported as average uniformity ± standard deviation, was uniform in the protected area without lights (95.8% ± 1.7%), but locally turbulent below the hemispherical closed-shaped (69.3% ± 14.6%), the semi-open column-shaped light (66.9% ± 10.9%), and in the surrounding zone (51.5% ± 17.6%). The RTs ranged between 1.1 and 1.7 min below the lights and 3.5 ± 0.28 min in the surrounding zone and depended exponentially on the volume flow rate. Conclusions: Compared to an RT of ≤20 min as required for operating rooms with mixed dilution flow, particles here were eliminated 12–18 times more quickly from below the surgical lights and 5.7 times from the surrounding zone. Thus, the effect of the lights was negligible and the UDF’s retained its strong protective effect.