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A new generation of hospital operating room ventilation

Time: Thu 2020-11-26 14.00

Location: Anmälan / Registration: https://kth-se.zoom.us/webinar/register/WN_XmcrRmGdSfi8I7i1Nzs1JQ, Du som saknar dator/datorvana kan kontakta Sasan Sadrizadeh ssad@kth.se / Use the e-mail address if you need technical assistance, Stockholm (English), Stockholm (English)

Subject area: Civil and Architectural Engineering, Fluid and Climate Theory

Doctoral student: Parastoo Sadeghian , Hållbara byggnader

Opponent: Professor Catherine Noakes, University of Leeds, United Kingdom

Supervisor: Docent Sasan Sadrizadeh, Hållbara byggnader

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Abstract

Surgical site infection is responsible for 38 percent of reported infections after surgery. This infection increases mortality and treatment costs, and prolongs the hospitalization of patients. Bacteria-carrying particles are the main cause of surgical site infection and one of the main sources of these particles is skin fragments released from the surgical personnel during an ongoing surgery. Ventilation systems reduce the concentration of bacteria-carrying particles by supplying clean air in the operating room. The performance of operating room ventilation systems is affected by internal disruptions such as medical equipment, surgical lamps, number of staff and their behaviour during the surgery.

Using computational fluid dynamics, this thesis investigates the airflow behaviour and distribution of the contamination in the operating room under the presence of various internal disruptions. In this regard, three common ventilation systems are considered: laminar airflow, turbulent mixing and temperature-controlled airflow ventilations. This study tries to overcome the weaknesses of the ventilation systems by providing sustainable solutions and continuously being in contact with design companies.

It is common to use warming blankets to prevent reduction in the core body temperature of the patient during major surgeries. However, there is a major concern that these blankets disrupt the supplied airflow, which results in rising contaminant concentration. Most of the studies about warming blankets are clinical works and it is still not clear whether or not these blankets should be used. The results of the present study show that using warming blankets had no impact on increase of contamination level at the surgical zone. However, one common type of warming blanket – a forced-air warming blanket – can considerably increase the concentration of bacteria-carrying particles at the wound area if it becomes contaminated.

The simulated results of the airflow field and particle tracking showed that the laminar airflow ventilation system was disturbed more easily by the local heat loads than overall heat loads in the operating room.

Surgical lamps are considered as an obstacle in the supplied airflow path. These lamps create a stagnant area above the operating table and increase the contamination level. In this regard, a novel design of surgical lamp, a fan-mounted surgical lamp, was introduced to operating rooms.This device was used in the operating rooms equipped with laminar airflow and mixing ventilation system. The simulated results revealed that this lamp significantly reduced the contamination level at the operating table.

Visualization techniques were adopted to teach and improve the understanding of surgical personnel about transmission of contaminated particles in operating rooms. Here, a virtual and augmented reality interface was used to visualize the impact of differences in ventilation principle, surgical staff constellation and work practice.

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