| 56 | Pacemaker implantation, implantable defibrillators and all other surgical procedures, involves the risk of infection. Infection remains the most common pacemaker-related complication after equipment failure and sensing and pacing defects. It is a significant cause of morbidity and mortality despite improved surgical techniques and the development of new pacemaker devices. If a pacemaker patient gets an infection the bacteria can persist even when the rest of the body is free of infection, causing the original blood poisoning illness to re-emerge at a later date, when it may even prove fatal. The only known solution to such infestation is the complete replacement of the device, which exposes the patient to more risks and costs. Coronary stent infection, although exceedingly rare, represents a life-threatening complication.
Toul Laminar Air Flow is reducing the level of contamination of airborne micro organisms significant by protecting the surgical site area as well as the instrument table via an ultraclean laminar airflow. Under normal circumstances, the main source of airborne microbial contaminants is microscopic skin fragments given off by staff in theatre. The contamination level in the operating room increases with the duration of the operation and the number of persons in theatre and hence increasing the risk of postoperative infection.
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Cardiology
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| 59 | Cataract surgery: There is a low but serious risk with this surgery which can result in loss of sight. Endophthalmitis causing widespread inflammation or infection of the eye can be a serious side effect of cataract surgery that can lead to permanent vision loss and even blindness. |
Ophthalmology
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| 62 | Interventional radiology is a rapidly growing area of medicine. The number of bacteria resistant to many different antibiotics has increased and hence the risk of hospital infection. More than 70 percent of the bacteria that causes hospital infections are resistant to at least one of the antibiotics commonly used to treat them. In many cases the instruments and implants e.g. stents are exposed to bacteria. Just a few minutes are sufficient to contaminate the instruments or implants. |
Interventional Radiology
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| 65 | Nosocomial infections are the most frequent complications observed in surgical oncological patients; despite considerable progress in the areas of prevention, diagnosis and therapy, postoperative infections continue to be associated with significant morbidity, sometimes with mortality and with extra expense to cover cost of antibiotics, blood derivatives, nursing, additional surgical procedures and prolonged hospitalization. Most surgical infections are acquired intraoperatively. The risk of postoperative surgical infections is mainly related to the magnitude of surgical field contamination related to the degree of bacterial contamination acquired from the skin or nasal flora of the operating team, or from contaminated material or instruments in the operating theatre. An English Study from Whyte has been estimated that almost 70% of bacteria found in the patient‘s wound s come directly or indirectly from the instruments. There is a clearly relationship between the quality of the air and the degree of sepsis encountered. 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. |
Oncology
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| 67 | Small numbers of organisms are sufficient to cause implant infections, which give rise to a considerable degree of morbidity and also mortality. The periprosthetic infection rates correlate with the number of airborne bacteria. It has been estimated that as few as 10 colony forming units (cfus) are sufficient to cause infections in prosthetic replacement arthroplasty. Typically, around 50-200 colony forming units per cubic metre (cfu/m3) of air are found in conventionally ventilated operating rooms. The bacteria’s that cause infections in implant surgery are mostly inoculated into the wound at the time of insertion of the implant. Airborne micro-organisms can fall directly into wounds or through exposed instruments. The main source of airborne microbial contaminants is microscopic skin fragments given off by staff in theatre. The patient is not usually a significant source of airborne contamination as their movement is usually minimal. It has been estimated that almost 70 % of bacteria found in patient’s wounds are transported indirectly via exposed instruments especially during long exposure time of instruments.
The introduction of laminar airflow systems has greatly reduced infection in implant surgery. Laminar flow, as opposed to turbulent flow, allows airborne particles to pass the operating area and prevent them from landing in the wound area. Adjustments to existing operating rooms is extremely expensive and in a lot of cases not possible due to the existing situation. Conventional airflow systems are mostly hindered by the surgical light and the heads of the operating team and increase the turbulences in the operating room.
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Plastic surgery
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| 77 | Postoperative veterinary infection (POI) is a common problem in veterinary surgery especially in orthopedic surgery. With the duration of the operation increases also the risk of an postoperative surgical wound infection. Small numbers of organisms are sufficient to cause implant infections, which give rise to a considerable degree of morbidity and also mortality. The introduction of laminar airflow systems has greatly reduced infection in orthopedic implant surgery. Laminar flow, as opposed to turbulent flow, allows airborne particles to pass the operating area and prevent them from landing in the wound area. Fixed laminar air flow systems are extremely expensive and therefore quite not affordable for many veterinary surgeons. With the new Toul mobile laminar airflow unit it has become possible to use laminar airflow also for veterinary surgery at an affordable price thus offering good hygienic conditions for veterinary operating rooms.
Toul mobile laminar airflow units have been used in Scandinavia since 2001, providing an ultraclean, horizontal flow of air directly over the surgical site and instruments and acting as a barrier to minimize the presence of bacteria-carrying particles at the wound and on the instruments.
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Veterinary
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| 57 | Small numbers of organisms are sufficient to cause implant infections, which give rise to a considerable degree of morbidity and also mortality. The periprosthetic infection rates correlate with the number of airborne bacteria. It has been estimated that as few as 10 colony forming units (cfus) are sufficient to cause infections in prosthetic replacement arthroplasty. Typically, around 50-200 colony forming units per cubic metre (cfu/m3) of air are found in conventionally ventilated operating rooms. The bacteria’s that cause infections in implant surgery are mostly inoculated into the wound at the time of insertion of the implant. Airborne micro-organisms can fall directly into wounds or through exposed instruments. The main source of airborne microbial contaminants is microscopic skin fragments given off by staff in theatre. The patient is not usually a significant source of airborne contamination as their movement is usually minimal. It has been estimated that almost 70 % of bacteria found in patient’s wounds are transported indirectly via exposed instruments especially during long exposure time of instruments.
The introduction of laminar airflow systems has greatly reduced infection in implant surgery. Laminar flow, as opposed to turbulent flow, allows airborne particles to pass the operating area and prevent them from landing in the wound area. Adjustments to existing operating rooms is extremely expensive and in a lot of cases not possible due to the existing situation. Conventional airflow systems are mostly hindered by the surgical light and the heads of the operating team and increase the turbulences in the operating room.
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Implant Surgery
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| 60 | Nosocomial infections are common following cardiac surgery, cardiovascular surgery and thorax surgery as well as pacemaker implants due to various risk factors that are contributing like age, duration of operation, general condition of patents etc. They are associated with prolonged lengths of hospitalization, the development of multiorgan dysfunction, and increased morbidity and hospital mortality. Infections after pacemaker implantation remains the most common pacemaker-related complication after equipment failure and sensing and pacing defects. Patients with pacemakers run the risk of potentially life-threatening infections if bacteria spread to infest their implant.
Toul Laminar Air Flow is reducing the level of contamination of airborne micro organisms significant by protecting the surgical site area as well as the instrument table via an ultraclean laminar airflow. Under normal circumstances, the main source of airborne microbial contaminants is microscopic skin fragments given off by staff in theatre. The contamination level in the operating room increases with the duration of the operation and the number of persons in theatre and hence increasing the risk of postoperative infection.
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Cardiac surgery
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| 63 | |
Neonates
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| 66 | Patients admitted into intensive care units (ICUs) are at great risk for acquiring nosocomial infections. They are susceptible to infection because of their underlying diseases or conditions associated with impaired immunity as well as several violations of their immune system or risks of aseptic mistakes in patient management during invasive monitoring and they are prone to secondary infections after exposure to broad-spectrum antimicrobials. ICU-acquired infections are to be associated with high mortality, excessive length of ICU and hospital stay, and high hospital costs. |
Intensive Care Unit
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| 68 | Instruments |
Instruments
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| 76 | Deep infection represents one of the most devastating complications of total knee arthroplasty and total hip arthroplasty imposing heavy emotional and financial tolls on the patient, the physicians involved, and
society as a whole. Conservative estimates of infection rates average 1-2% for hip implants and 2-4% for knee implants. The number of joint replacements is expected to double in the next twenty years
and if the infection rate is not reduced, also the incidence of infection will double, yielding
increased morbidity, hospital stay and costs for the healthcare system. Infections can be caused during surgery by direct contact with the wound or airborne colonization. It has been suggested that the main sources of contamination are the patient’s skin and airborne particles from theatre personnel. The introduction of laminar airflow systems has greatly reduced infection in orthopaedic implant surgery. Laminar flow, as opposed to turbulent flow, allows airborne particles to pass the operating area and prevent them from landing in the wound area. Adjustments to existing operating rooms is extremely expensive and in a lot of cases not possible due to the existing situation.
Toul mobile laminar airflow units have been used in Scandinavia since 2001, providing an ultraclean, horizontal flow of air directly over the surgical site and instruments and acting as a barrier to minimize the presence of bacteria-carrying particles at the wound and on the instruments
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Orthopaedics
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| 54 | Toul creates immediate sterile conditions for army field hospitals, surgical field hospitals or wherever you need it. A combination of Laminar Air Flow and high efficient HEPA filters ensures sterile laminar airflow especially for the application of operating theatre suites (operating room- surgical room) |
Field hospital
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| 58 | Vascular by-pass surgery is being used increasingly more frequently on elderly patients entailing several risk factors. Surgical infections in these procedures are a devastating complication which is related to serious complications with high mortality and limb amputation. Significant increases in prevalence of resistance to antibiotics have been observed worldwide. MRSA infection is a significant risk factor for adverse clinical outcomes among patients undergoing vascular surgery procedures. Therefore it is more and more important to reduce the contamination level especially in the operating field and instruments to prevent all sources of contamination during the surgical operation. A main problem especially in longer operations is the contamination of surgical instruments due to human presence and their activity within the operating room. An English Study from Whyte has been estimated that almost 70% of bacteria found in the patient‘s wound s come directly or indirectly from the instruments. There is a clearly 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. 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. As few as 10 colony forming units (CFU/m3) are sufficient to cause a deep infection. |
Vascular surgery
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| 61 | Infections associated with neurosurgery can be disastrous. Conservative estimates of infection rates average 2-5% Significant increases in prevalence of resistance to antibiotics have been observed worldwide. The danger from hospital infections is worsening because, increasingly, they cannot be cured with commonly used antibiotics.Therefore it is more and more important to reduce the contamination level especially in the operating field and instruments to prevent all sources of contamination during the surgical operation. A main problem in neurosurgery especially in long operative time is the contamination of surgical instruments due to human presence and their activity within the operating room. An English Study from Whyte has been estimated that almost 70% of bacteria found in the patient‘s wound s come directly or indirectly from the instruments. There is a clearly 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. 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. |
Neurosurgery
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| 64 | The risks associated with plastic, cosmetic, and reconstructive surgery include the postoperative complications like infection inside the body related to inserting a prosthesis. Women undergoing breast implant surgery have a 2.5% risk of suffering a post-op infection, a worldwide study of 10,000 people suggests. For cancer patients having breast reconstruction the risk is up to 10 times higher(University of Geneva; Lancet Infectious Diseases journal 2005). Risk associated with breast reconstruction after cancer treatment is much higher as radiotherapy and chemotherapy mean wounds do not heal as well. These infections can result from contamination at the time of surgery or from bacteria migrating into the area around the prosthesis at a later time. Significant increases in prevalence of resistance to antibiotics have been observed worldwide. The danger from hospital infections is worsening because, increasingly, they cannot be cured with commonly used antibiotics. Therefore it is more and more important to reduce the contamination level especially in the operating field and instruments to prevent all sources of contamination during the surgical operation. An English Study from Whyte has been estimated that almost 70% of bacteria found in the patient‘s wound s come directly or indirectly from the instruments. There is a clearly relationship between the quality of the air and the degree of sepsis encountered. 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. |
ENT
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| 69 | Penile prosthesis implantation remains an effective and acceptable treatment for the significant number of men who fail to respond to nonsurgical therapy. The most serious complication that can affect the use of most prosthetic devices is infection. In penile prostheses, this can be devastating and frequently results in removal of the device despite aggressive antibiotic therapy. Toul can be used to minimize the risk of postoperative infections also in obstetrics and gynecology. Most surgical infections are acquired intraoperatively. The risk of postoperative surgical infections is related to the degree of bacterial contamination acquired from the skin or nasal flora of the operating team, or from contaminated material or instruments in the operating theatre. An English Study from Whyte has been estimated that almost 70% of bacteria found in the patient‘s wound s come directly or indirectly from the instruments. There is a clearly relationship between the quality of the air and the degree of sepsis encountered. 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 |
Gynecology, Urology, Obstetrics
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| 78 | Transplantation of organs has become a successful modality for treatment of organ diseases. Improved techniques for organ preservation, surgical procedures, rejection management, and posttransplant infection prophylaxis and treatment have contributed to this success. Most identifiable of the advances in solid organ transplantation (SOT) is the development of potent immunosuppressive agents. However, the use of these agents in the prevention and management of rejection is closely interrelated to the development of infection.
Infection is the most important cause of early morbidity and mortality following transplantation.
The development of prophylactic strategies for bacterial, viral, fungal, and protozoal organisms has contributed to a decrease in infectious complications and an increase in patient survival. However, the development and emergence of antimicrobial-resistant microbes (eg, vancomycin-resistant enterococci [VRE], methicillin-resistant Staphylococcus aureus [MRSA], penicillin-resistant pneumococci, ganciclovir-resistant cytomegalovirus [CMV], and azole-resistant Candida species); fungi (eg, Fusarium, Alternaria,and Scedosporium); and opportunistic bacteria (eg, Rhodococcus equi and Nocardia species) makes it necessary to get the best sterile conditions during operations to minimize the risk of postoperative infection. Currently, the most common infectious problems within the first month following transplantation are bacterial infections of the wound. They are associated with prolonged lengths of hospitalization and increased morbidity and mortality.
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Transplantation
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