Motion-capture system to assess intraoperative staff movements and door openings: Impact on surrogates of the infectious risk in surgery

Abstract

We longitudinally observed and assessed the impact of the operating room (OR) staff movements and door openings on surrogates of the exogenous infectious risk using a new technology system.Design and setting: This multicenter observational study included 13 ORs from 10 hospitals, performing planned cardiac and orthopedic surgery (total hip or knee replacement). Door openings during the surgical procedure were obtained from data collected by inertial sensors fixed on the doors. Intraoperative staff movements were captured by a network of 8 infrared cameras. For each surgical procedure, 3 microbiological air counts, longitudinal particles counts, and 1 bacteriological sample of the wound before skin closure were performed. Statistics were performed using a linear mixed model for longitudinal data.Results: We included 34 orthopedic and 25 cardiac procedures. The median frequency of door openings from incision to closure was independently associated with an increased log10 0.3 m particle (β, 0.03; standard deviation [SD], 0.01; P =.01) and air microbial count (β, 0.07; SD, 0.03; P =.03) but was not significantly correlated with the wound contamination before closure (r = 0.13; P =.32). The number of persons (β, -0.08; SD, 0.03; P