Wound ventilation with carbon dioxide: A simple method to prevent direct airborne contamination during cardiac surgery?

Journal of Hospital Infection

Volumn 56, Issue 2, 2004, Pages 131-136

  Persson, M ^a   van der Linden, Jan ^a  

^a KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Carbon dioxide; Cardiac surgery; Cardiothoracic wound cavity; Infection

Indexed keywords

AGAR; CARBON DIOXIDE;

AIR; AIR EMBOLISM; AIRFLOW; ARTICLE; BACTERIUM CONTAMINATION; CONTROLLED STUDY; DIFFUSION CHAMBER; HEART SURGERY; INFECTION PREVENTION; INFECTION RATE; INFECTION RISK; INTRAOPERATIVE PERIOD; NONHUMAN; POSTOPERATIVE INFECTION; RISK REDUCTION; SURGICAL EQUIPMENT; SURGICAL INFECTION; TUBE;

AIR MICROBIOLOGY; CARBON DIOXIDE; CROSS INFECTION; HEART DISEASES; HUMANS; INSUFFLATION; OUTCOME ASSESSMENT (HEALTH CARE); SURGICAL WOUND INFECTION; SWEDEN; THORACIC SURGICAL PROCEDURES;

EID: 0742302584     PISSN: 01956701     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jhin.2003.10.013     Document Type: Article

References (33)

1. Verkkala K. Occurrence of and microbiological findings in postoperative infections following open-heart surgery. Effect on mortality and hospital stay Ann Clin Res 19 1987 170-177
2. L'Ecuyer P.B. Murphy D. Little J.R. Fraser V.J. The epidemiology of chest and leg wound infections following cardiothoracic surgery Clin Infect Dis 22 1996 424-429
3. Zacharias A. Habib R.H. Factors predisposing to median sternotomy complications. Deep vs superficial infections Chest 110 1996 1173-1178
4. Bitkover C.Y. Gardlund B. Mediastinitis after cardiovascular operations: a case-control study of risk factors Ann Thorac Surg 65 1998 36-40
5. Fowler V.G. Jr. Kaye K.S. Simel D.L. et al. Staphylococcus aureus bacteremia after median sternotomy: clinical utility of blood culture results in the identification of postoperative mediastinitis Circulation 108 2003 73-78
6. Wells F.C. Newsom S.W. Rowlands C. Wound infection in cardiothoracic surgery Lancet 1 1983 1209-1210
7. Davies R.R. Noble W.G. Dispersal of bacteria on disseminated skin scales Lancet 1962 1295-1297
8. Alexakis P.G. Feldon P.G. Wellisch M. Richter R.E. Finegold S.M. Airborne bacterial contamination of operative wounds West J Med 124 1976 361-369
9. Howorth F.H. Prevention of airborne infection during surgery Lancet 1 1985 386-388
10. Mackintosh C.A. Lidwell O.M. Towers A.G. Marples R.R. The dimensions of skin fragments dispersed into the air during activity J Hyg (Lond) 81 1978 471-479
11. Sciple G.W. Riemensnider D.K. Schleyer C.A.J. Recovery of microorganisms shed by humans into a sterilized environment Appl Microbiol 15 1967 -1388
12. Bitkover C.Y. Marcusson E. Ransjo U. Spread of coagulase-negative staphylococci during cardiac operations in a modern operating room Ann Thorac Surg 69 2000 1110-1115
13. Verkkala K. Eklund A. Ojajarvi J. Tiittanen L. Hoborn J. Makela P. The conventionally ventilated operating theatre and air contamination control during cardiac surgery-bacteriological and particulate matter control garment options for low level contamination Eur J Cardiothorac Surg 14 1998 206-210
14. Taylor G.J. Bannister G.C. Infection and interposition between ultraclean air source and wound J Bone Joint Surg Br 75 1993 503-504
15. Nichols H.T. Morse D.P. Hirose T. Coronary and other air embolization occurring during open cardiac surgery. Prevention by the use of gaseous carbon dioxide Surgery 43 1958 236-244
16. Martens S. Dietrich M. Wals S. Steffen S. Wimmer-Greinecker G. Moritz A. Conventional carbon dioxide application does not reduce cerebral or myocardial damage in open heart surgery Ann Thorac Surg 72 2001 1940-1944
17. Martens S. Dietrich M. Doss M. Wimmer-Greinecker G. Moritz A. Optimal carbon dioxide application for organ protection in cardiac surgery J Thorac Cardiovasc Surg 124 2002 387-391
18. Persson M. van der Linden J. De-airing of a cardiothoracic wound cavity model with carbon dioxide: theory and comparison of a gas diffuser with conventional tubes J Cardiothorac Vasc Anesth 17 2003 329-335
19. Svenarud P. Persson M. van der Linden J. Intermittent or continuous carbon dioxide insufflation for de-airing of the cardiothoracic wound cavity? An experimental study with a new gas-diffuser Anesth Analg 96 2003 321-327
20. Rosen M. Replacement of air by carbon dioxide Anesthesiology 89 1998 -1036
21. Ng S.W. Rosen M. Carbon dioxide in the prevention of air embolism during open-heart surgery Thorax 23 1968 194-196
22. Persson M, Svenarud P, van der Linden J. Which is the optimal device for carbon dioxide de-airing of the cardiothoracic wound and how should it be positioned? J Cardiothorac Vasc Anesth, accepted for publication.
23. Friberg B. Friberg S. Burman L.G. Correlation between surface and air counts of particles carrying aerobic bacteria in operating rooms with turbulent ventilation: an experimental study J Hosp Infect 42 1999 61-68
24. Lidwell O.M. Lowbury E.J. Whyte W. Blowers R. Stanley S.J. Lowe D. Airborne contamination of wounds in joint replacement operations: the relationship to sepsis rates J Hosp Infect 4 1983 111-131
25. Arnold M. The surgical anatomy of sternal blood supply J Thorac Cardiovasc Surg 64 1972 596-610
26. Whyte W. Hodgson R. Tinkler J. The importance of airborne bacterial contamination of wounds J Hosp Infect 3 1982 123-135
27. Streeter V.L. Wylie B.E. Bedford K.W. External flows In: Munson E, editor Fluid mechanics 9th edn 1998 McGraw-Hill New York, NY 327-328
28. Noble W.C. Lidwell O.M. Kingston D. The size distribution of airborne particles carrying micro-organisms J Hyg Camb 61 1963 385-391
29. Dugid J.P. The size and the duration of air-carriage of respiratory droplets and droplet-nuclei J Hyg Camb 44 1964 471-479
30. Noble W.C. Dispersal of skin microorganisms Br J Dermatol 93 1975 477-485
31. Whyte W. Sterility assurance and models for assessing airborne bacterial contamination J Parenter Sci Technol 40 1986 188-197
32. Taylor G.J. Leeming J.P. Bannister G.C. Assessment of airborne bacterial contamination of clean wounds: results in tissue model J Hosp Infect 22 1992 241-249
33. Persson M. Flock J.-I. van der Linden J. Antiseptic wound ventilation with a gas-diffuser: a new intraoperative method to prevent surgical wound infection? J Hosp Infect 54 2003 294-299