Improvement of operating room air quality and sustained reduction of surgical site infections in an orthopedic specialty hospital

Introduction Surgical site infection (SSI) rates can be impacted by air quality, and a high efficiency particulate air (HEPA)/ultraviolet (UV) air recirculation system (HUAIRS) has been shown to improve operating room (OR) air quality. This study examined the impact of HUAIRS devices on SSI rates when used at an orthopedic specialty hospital. Materials and Methods HUAIRS devices were used intraoperatively at the facility. Total particle counts (TPC) before and after HUAIRS implementation were compared. SSI rates for nervous system procedures or for all procedures at the facility were also compared for the 2.5-year periods before and after implementing HUAIRS devices. Results Over 30,000 consecutive procedures were performed from 2017 to 2022. The overall SSI rate at the facility was 0.45% before implementing HUAIRS devices compared to 0.22% (P < 0.001) after. The SSI rate following nervous system procedures was 2.06% before implementing HUAIRS devices versus 0.29% (P < 0.001) after. TPCs were also significantly lower after implementing HUAIRS devices. Discussion and Conclusion Implementation of HUAIRS devices at an orthopedic specialty hospital was associated with significant reductions in SSI rates and intraoperative air contamination levels. These data support the need to further investigate intraoperative air quality interventions on the reduction in SSI rates.