microbial burden in OR air. Portable units positioned next to the OR
table direct a sterile airflow across patients and instruments, creating
a sterile barrier over the surgical wound. Another system is integrated
into ceiling lights to provide continuous air purification. Air is pulled
into the system, treated with UV-C light and pushed back out into the
room.
I was involved in a recent research project that measured the
impact an innovative UV-C air decontamination unit had on joint
replacement infection rates. During the study, the same ortho team
operated on 496 patients who had similar comorbid conditions. The
surgeries were performed in 2 ORs with identical HVAC laminar flow
systems. The one variable in the study was the use of the UV-C unit,
which was positioned within one of the ORs during 231 cases. In the
OR without the UV-C technology, a total of 5 post-op infections
occurred out of 265 procedures, reflecting a 1.9% infection rate, which
is a typical rate observed in joint replacement surgery. No infections
occurred in patients whose surgeries took place in the OR where the
UV-C air decontamination unit was used (osmag.net/KvxB4W).
A caveat: The relatively small trial was essentially a pilot study, not
randomized controlled research. Still, the results are interesting and
suggest UV-C technology can reduce the risk of periprosthetic device
infections by reducing the airborne microbial population within the
OR environment.
Skin in the game
There are many barriers to improving infection control practices,
including a lack of administration support for embracing evidence-
based risk-reduction technologies. The reasons for this reluctance
vary from facility to facility, but cost and a failure to understand how
these innovative technologies can be successfully integrated into a
5 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 9
