Toul mobile laminar air flow - Normeditec presentation english 2014.pdf · Toul mobile laminar air...
Transcript of Toul mobile laminar air flow - Normeditec presentation english 2014.pdf · Toul mobile laminar air...
Toul mobile laminar air flow
Toul pendant system Toul steristay
Toul mobile «operio»
A system from Sweden to reduce the
infections in the operating room and field
hospitals
New 2014!
The main source of airborne microbial contaminants
is microscopic skin fragments given of by staff
theatre. The patient is not usually a significant source
of airborne contamination; their movement is usually
minimally. Movement can shed up to 10 000 skin
scales per minute, of which 10 % carry clusters of
micro-organisms. These will contain Staphyloccocus
aureus and coagulase-negative staphylococci which
are frequent causes of infection. (Noble W.C.: Dispersal of skin microorganism (Review). Brit. J.
Dermatol. 93: 477-490, 1975.)
MRSA in Europe
2002 2005
.
Extreme reduction of
bacteria contamination
Conventional airflow systems do mostly not arrive
at the operating field as they are hindered by the
surgical light and the heads of the operating
team.
Toul is positioned very close to the operating field
and therefore it is possible to reduce the
contamination level by almost 95 % for the
operating field and Toul instrument table.
.
A main problem especially in longer operations is
the contamination of surgical instruments due to
human presence and their activity within the
operating room.
As few as 10 colony forming units (CFU/m3) are
sufficient to cause a deep infection*. Gosden PE, Mac
GowanAP Bannister GC J. Hosp Infect 1998;
In an conventional operating room you can expect about 50 to 200 CFU/m3. This
number is rising the more people are in the operating room and the longer the
operation last
An English Study from Whyte has been estimated
that 98 % of bacteria found in the patient‘s wounds
come directly (30 %) or indirectly (70 %,
instruments!) from the air. There is a clear
relationship between the quality of the air and the
degree of sepsis encountered. Under normal
circumstances, the main source of airborne microbial
contaminants is microscopic skin fragments given off
by staff in theatre.
Richard I. Whyte Stanford University Medical Center,
Cardiothoracic Surgery
(70 % of the bacteria found in the
patients wound are coming
indirectly (e.g. instruments!) via
the air Stafilococco Aureo
Pseudomonas
Toul guarantees sterile conditions in the
operating field and on the instrument table even
in extreme conditions. Toul can be used
immediately due to sterile screens which are to
be exchanged just before the operation starts
and guarantee a maximum sterility .
Conventional operating room ventilation
Author Number of
Patients
Conventional
operating room
(%)
Charnley 5.800 7 %
Nelson 15.520 5,8 %
D. Lew et al. 1.880
2.730
5,8 %
Jenny et al. 1.354
5,7 %
Studies of infection with conventional operating
room
In an conventional operating room you can expect about 50 to
200 CFU/m3.
Laminar Air flow
Author Number of
Patients Laminar
Air Flow
(%) Charnley 5.800 0,5 %
Nelson 15.520 0,7 %
D. Lew et al 1.880
2.730
0,7 %
Lidwell 8000 0,6 %
Jenny et al. 1.354 0,9 %
Studies of infection with Laminar air flow
≤ 20 UFC/m3 (it depends on the number of persons and
the duration of the operation
Contamination level in the operating room
Conventional
Operating room
Laminar
Flow
With Toul
50-200
CFU/m3 (depending on the
duration of the operation
and the number of
persons in the O.R.)
≤ 20
CFU/m3
< 5 CFU/m3
Conventional
operating room
Laminar
Flow
Toul Instrument
table
50-200
CFU/m3
(depending on the
duration of the operation
and the number of
persons in the O.R.
≤ 20
CFU/m3
< 1 CFU/m3
CFU’s on the instrument table
Mobile unit for laminar sterile air
-Filter HEPA: 99,999% DOP
- Air quantity: max.480mc/h
-Speed of air: 0,5mt/sec
-Power supply: 230 VAC ,50Hz
-Consumption: 260W
-Weight:42Kg
The use of antibiotics in surgery represents about
40-50% of the total consumption of antibiotics in
hospitals. This increases the risk of resistance
against antibiotics like Staphilococcus aureus,
Pseudomonas, Escherichia coli e Acinetobacter
baumanii
Hospitals do have more and
more bacteria's with resistance
against antibiotics
(CBS) In 1974, only two percent of staph germs were
MRSA. By 1995, 22 percent were, and now that number is
over 60 percent, and still rising. Patients who survive these
drug-resistant germs sometimes have to spend months in the
hospital and go through many surgeries to cut out infected
tissue. 37 new antibiotics were put on the market in the years
80-90. In the nineteen's there were 7 new antibiotics
and for the next 10 years there are only two new
antibiotics foreseen!!
The research for a new antibiotic costs more than 500
million Euro and ten years of studies. A lot of big
companies are not ready to invest anymore in this
sector as it is not lucrative anymore.
Aprile 2006, Antibiotics in 10 to 15 years without use?
According to an information of the WHO which was
published in April 2006 we risk that in 10 to 15 years
the antibiotics are useless. The germs have become
more and more resistant to antibiotics.
Hospital Infection Deaths USA
Infections contracted in hospitals are the fourth largest killer in the U.S., causing as many deaths as AIDS, breast cancer and auto accidents combined. Hospital infections are now the fourth leading cause of death in the United States, behind heart disease, cancer and strokes, according to the Centers for Disease Control Nationwide more than 90,000 people every year die, 2 million people annually become ill from hospital-acquired infections. That's more than auto accidents and murders combined. Serious cases of antibiotic resistant infections cannot be cured, may destroy flesh and bones, require multiple surgeries, and often result in death. (CBS NEW YORK, June 8, 2005 ) (
ANTIBIOTIC RESISTENTENCE IN EUROPA
(Verona, 20-21 November 2005 – Maria Luisa Moro)
Costs of Infections
The average cost to treat a Pennsylvania hospital (USA) patient who developed an infection was $29,000, compared with $8,300 for those who did not, the report found. Ceci Connolly Washington Post, July 13, 2005;
TORONTO, Ont. -- Duke University Medical Center researchers "We found that average hospital stay due to methicilin-resistant S. aureus (MRSA) was 12 days longer, compared to four days longer for methicilin-susceptible S. aureus (MSSA)," "In terms of added cost, the average due to MRSA infections was $27,082, compared to $9,661 for MSSA.(Dr. Murray Abramson, Duke infectious disease physician 9/28/1997) As an example, Abramson cited penicillin, the first effective antibiotic. "When penicillin was first introduced in the 1940s, it was effective against almost all S. aureus strains. Today, about 99 percent of S. aureus is resistant to penicillin
Estimates from South Australia indicate each hospital-acquired infection costs
$22,000, making the annual bill $150 million (Dr Collignon, an infectious diseases specialist and microbiologist at Canberra Hospital April 9, 2005)
A study from the hospital Sacco di Milan (2006) estimates that every infection costs about 9.000€
Type of operation
S S I
Risk factors Duration of operation
Condition of Patient
Clinical tests and
CFU-values
Sedimentation
plate with cfu/m3
Sartorius
Karolinska, Sweden
OP Result
CFU/m3
1 <1
2 <1
3 <1
4 1
5 <1
6 50 *
7 <1
*TOUL switched off
Pacemaker Hospital Stockholm-
Operation from 21 to 27
April 2005
OP Results in CFU/m3
Operation 1 0,5
Operation 2 1
Operation 3 0
Operation 4 1,5
Operation5 0
Operating Room
233 (99-383)
0
10
20
30
40
50
60
70
80
90
100
110
120
130
140
150
160
170
180
190
200
210
220
230
240
250
Operation
1
Operation
2
Operation
3
Operation
4
Operation
5
2005-04-27
CFU/m³ withToul 400
CFU/m³ withToul 300
CFU/m³reference
CFU-measurements at Södersjukhuset hospital
Reference: Measurements without Toul 400
Pacemaker implant
Measurements performed by Karolinska university hospital hygienedep.
Mobile zoned/exponential LAF screen - a promising new concept
in ultra-clean air technology for additional operating room ventilation B. Friberg*, M. Lindgren*, C. Karlsson†, A. Bergström* and S. Friberg‡
*Departments of Nursing, †Clinical Microbiology and ‡Orthopaedic, Umeå University, S-901 86 Umeå, Sweden
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Instrument table Wound area Patient area
Surface contamination of bacteria
during surgery in cfu/m2/h2
With Toul Without Toul
Advantages
2
3
4
6
7
8
Quick and easy solution for producing sterile air
Keeps the operating field sterile even in extreme conditions
Sterile air in wound area
Elimination of smoke during electro surgery
Easy to use
Easy to clean
1 Reduction of the contamination on surgical site
5 Easy to move
Use 1
2
3
4
5
6
7
8
10
9
Day-Hospital
Field hospitals
After natural catastrophes
Keeping sterile conditions for instruments during surgery
Emergency department
High risk patients
Burned Patients, e.g. after terrorists attack
Implantation surgery
Patients who are undergoing chemotherapy
Field hospitals
Toul guarantees sterile conditions in the
operating field and on the instrument table even
in extreme conditions. Toul can be used
immediately due to sterile screens which are to
be exchanged just before the operation starts
and guarantee a maximum sterility .
Othopaedics
Cardiology
Oftalmology
Othopaedics
• Normeditec srl
• www.normeditec.com
• info@normeditec .com
• Tel +39 3487302445