Cherwell, the cleanroom microbiology solutions expert, has developed a new peel-apart pack settle plate product to support a UK national study investigating the relationship between the microbiological quality of operating theatre air and infection rate.
Supported by NHS England, the UK Health Security Agency, and British Orthopaedic Association, the JOINTCASE audit aims to check the air quality of ultraclean air (UCA) operating theatres while in use for surgery. Cherwell explains that ‘despite the well-documented relationship between microbiological air quality and deep infection rates, it is not routine to monitor operating theatres when in use’. It said: “This is because slit samplers are traditionally used to test air quality by volumetric counting, but these are labour-intensive, requiring trained individuals, and impractical for routine audits. The study management group noted settle plate counting to be a simpler methodology, and its relationship with volumetric counting well established.”
Conducted jointly by local orthopaedic and microbiology/infectious disease departments in elective orthopaedic units nationwide, the audit now uses a settle plate-based technique. For this, packs of 10 microbiology plates, which can be simply peeled apart aseptically for easy sterile dispensing onto surgical instrument trolleys and next to the wound, were specially developed by Cherwell. To further minimise contamination risk, during transfer for incubation after exposure, the plates can be secured with sterile elastic bands, which are also supplied within the packs.
The new peel-apart packs were required as settle plates are generally packed double or triple wrapped and sterilised for laboratory or cleanroom use, which is not sufficient during surgery in an operating theatre. Study lead and orthopaedic surgeon, Andrew Thomas, of The Royal Orthopaedic Hospital, Birmingham, explained: “Regular plate packs must be opened in a completely aseptic way using sterile scissors – an additional task for the scrub person. It distracts them, and there is a risk of de-sterilising the outside of the settle plates. The logical answer was to have a peel-apart pack, which can be dispensed onto the sterile instrument trolley, just like any other piece of equipment dispensed to the scrub nurse by the circulating staff, but this wasn’t available on the market.”
The Joint Orthopaedics and Infectious diseases National Theatre Clean Air Services Evaluation (JOINTCASE) is an ongoing national, multi-centre, prospective audit. All elective orthopaedic units in the UK are encouraged to participate in the study. This includes major elective centres, tertiary units, and district general hospitals. Initially, the audit will focus on UCA theatres used for joint replacement surgery in the UK.
