Ventilation Performance in Operating Rooms : A Numerical Assessment

Sammanfattning: Surgical site infections (SSIs) remain one of the most challenging postoperative complicationsof healthcare and threaten the lives of millions of patients each year. Current evidence hasshown a positive relationship between the airborne concentration of bacteria-carryingparticles (BCPs) in the operating room (OR) and the rate of infections. The OR ventilation iscrucial for mitigating the dispersion of airborne bacterial contaminants and thus controllingthe risk of SSIs. A variety of ventilation schemes have been developed for OR use. Each haspros and cons and may be better suited than another for operations under certain conditions.The proper functioning of OR ventilation is also affected by external and internal disruptions.By applying Computational Fluid Dynamics (CFD), the present study investigates the airflowand contaminant distribution in ORs under different conditions.The airflow distribution is of critical importance in removing or diluting airbornecontaminants. The conventional mixing ventilation is not able to reliably create an ultracleanenvironment. The usage of mixing ventilation in infection-prone surgery should be limited,especially when a large surgical team is involved. Laminar airflow (LAF) ventilation demandsa sufficient airflow rate to achieve desired performance. Temperature-controlled airflow(TAF) ventilation represents an effective ventilation scheme that can serve as an energyefficientalternative to LAF.Door openings have a detrimental impact on the microbiological cleanliness of the OR. Thetemperature in the OR and adjacent space should be well controlled to minimize the interzonalcontaminant transfer. Temporarily reducing the OR exhaust flow during door operationforms a directional airflow towards the adjacent space, which is found to be an effectivesolution to ensure the isolation.Surgical lamps serve as physical obstructions in the airflow path and significantly deterioratethe performance of LAF ventilation. It is highly recommended to improve the shape anddesign of the lamps in the LAF ventilation. TAF is found to be less sensitive to the presenceof surgical lamps in the airflow path. The buoyancy-driven airflow used by TAF is morecapable of circumventing obstacles than the inertia-driven flow used by LAF. Thermal plumesdeveloped from the surgical equipment in the OR have the potential to distort the buoyancydrivenairflow in TAF.The thesis conducts a comprehensive literature review of important topics in OR ventilation.The present study enhances the understanding of the strengths and limitations of differentventilation schemes and increases the knowledge of the design and usage of OR ventilation.