Testing Temperature-Controlled Air Flow in Operating Rooms


Since The Netherlands has the most rigorous standards for operating room air quality in the world, it was the perfect place to test if the air quality concept created by Maximuse fulfilled the governmental requirement. These results were presented the 2023 AORN conference.

“In The Netherlands, [operating rooms] ORs in which infection-prone surgeries are performed may have a maximum of equal to or fewer than 10 CFU/m3 and are required to maintain a mean value of equal to or fewer than 5 CFU/m3. This is one of the most rigorous standards for OR air quality in the world,” the authors explained on a poster at the Association of PeriOperative Nurses (AORN) 2023 Conference in San Antonio, Texas, held from April 1-4, 2023. During the “Meet the Poster Authors” session, Infection Control Today® (ICT®) spoke with Remko Noor, CTO of Maximuse, from The Netherlands.

ICT: Please explain your poster to ICT’s audience.

We [at Maximuse] develop concepts for especially vulnerable surgical procedures. And in that case, we had to do some stress test to see if the OR is safe for patient treatments, especially orthopedic treatment. And we developed a new OR concept with a new ventilation principle. And that makes it difficult to convince people, and that's the reason why we did a stress test with different surgical procedures, which are simulated in an OR in Sweden. Because that is where it was installed, and there we started with a knee procedure with a little [number] of people and a low equipment rate. Then we added extra people inside the OR, insert extra heat loads to see what the effect on the airflows [was]. At the end, we did an emergency setup to see what happens if all rules are gone. All protocols are gone. But still is it safe to operate [on] a patient or to create an environment for patients which will be dangerous?

We see that the results [of the extreme conditions] are still below the 10 CFUs in the whole OR per cubic meter. In the wound area, we stay below 5 CFUs, which means it's still a very ultra-clean environment for surgical procedures.

[The poster stated, “Our conclusion is that the system is robust and disturbances have a minimum impact on functionality.”]

ICT: What information do you hope readers of your poster take home?

RN: I hope they take home that it's very easy to innovate, to create solutions, but you have to be open to them. And that means not only sticking to the guidelines but sometimes looking for different opportunities with the same level of security but other solutions.

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