Martin Scherrer

Comparison of Reusable and Disposable Laparatomy Pads

Laparotomy pads made of cotton are used in operative medicine as a tamponade, and as a means of preventing organ injury. In our study, the environmental impact and hygienic aspects of reusable and disposable laparotomy pads (also made of cotton) were investigated. The study is no complete LCA, but rather a life cycle inventory (LCI).Reusable laparotomy pads are superior as far as energy consumption, water and production of waste are concerned. Disposable laparotomy pads have a larger impact on the environment, causing a greater consumption of resources. The environmental impact caused by their production is much greater than the environmental impact of cleansing the reusable laparotomy pads. On the one hand, growing cotton and producing laparotomy pads requires much more water than the cleansing procedure for reusable pads. On the other hand, washing reusable laparotomy pads and bleaching with sodium hypochlorite results in the formation of adsorbable organic halogen compounds (AOX). Reprocessing laparotomy pads made of cotton meets the hygienic standards when the requirements for the special cleaning procedures are fulfilled.

SHUTTING DOWN OPERATING THEATER VENTILATION WHEN THE THEATER IS NOT IN USE: INFECTION CONTROL AND ENVIRONMENTAL ASPECTS

OBJECTIVE In hospital operating rooms (ORs), specially conditioned air is supplied to protect patients from airborne agents that may cause infections. This study investigated whether it is hygienically safe to shut down the air supply at night if measures are taken to ensure a timely restart before surgery is performed. DESIGN Experimental study. SETTING Neurosurgical OR of a German university hospital. METHODS The ventilation system was switched off and restarted after 10 hours. Particles suspended in the air near the operating table were counted, OR temperature was measured, and settle plates were exposed and incubated. RESULTS In 13 investigations, a median of 1.3 x 10(4) particles 0.5 microm/m3 or greater (range, 5.8 x 10(3) to 1.1 x 10(5)) were documented immediately after restart in the morning. After 10 minutes and subsequently, no test showed a particle count exceeding the threshold limit of 1.0 x 10(4) particles 0.5 microm/m3 or greater recommended by the German Society of Hygiene and Microbiology. Only a few colony-forming units (CFU) were detected per settle plate (median, 0 CFU/60 cm2; range, 0 to 8) and OR temperatures quickly reached normal levels. CONCLUSIONS Shutting down OR ventilation during off-duty periods does not appear to result in an unacceptably high particle count or microbial contamination of the OR air shortly after the system is restarted. Because substantial energy and cost savings are likely, this should be considered in hygienically safe heating, ventilation, and air conditioning systems. However, normal ventilation should be established at least 30 minutes before surgical activity.