Effect of turbulent and laminar flow mechanisms on air flow patterns and CO2 distribution in an operating room: A numerical analysis abbreviated title: Air flow pattern in an operating room

Document Type : Article

Authors

1 Department of Mechanical Engineering, Chabahar Maritime University, Chabahar, Iran

2 - Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran - Department of Mechanical Engineering, University of British Columbia, 6250 Applied Science Ln, Vancouver, BC, Canada

Abstract

Considering the risk of infection in surgeries, maintaining an acceptable indoor air quality in the operating rooms (ORs) to ensure the health and safety of patients and surgical team is very essential. Since airflow is one of the primary mechanisms for transmitting of infections and pollution, it is crucial to examine the air distribution systems in the ORs. In the present study the effect of turbulent and laminar airflow (TAF/ LAF) systems on the air and CO2 distribution in an OR was examined. The effects of inlet and outlet configurations were evaluated for seven different models. The results indicated that the LAF systems is superior over TAF systems. Based on the findings, the LAF with the air curtain configuration brings about the minimum CO2 concentration level in the OR. The results showed that LAF with the air curtain model is able to decrease the CO2 concentration by about 64.66% and 88.96% on central plane, which passes along the body patient on 1.14 m and 1.7 m above the floor, respectively compared to the existing model.

Keywords


References:
1. Berrios-Torres, S.I., Umscheid, C.A., Bratzler, D.W., et al. "Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017", JAMA Surg., 152(8), pp. 784-791 (2017).
2. Coello, R., Charlett, A., Wilson, J., et al. "Adverse impact of surgical site infections in English hospitals", J. Hosp. Infect., 60(2), pp. 93-103 (2005).
3. Sadeghian, P., Wang, C., Duwig, C., et al. "Impact of surgical lamp design on the risk of surgical site infections in operating rooms with mixing and unidirectional air flow ventilation: A numerical study", Journal of Building Engineering, 31, p. 101423 (2020).
4. Loomans, M., De Visser, I., Loogman, J., et al. "Alternative ventilation system for operating theaters: Parameter study and full-scale assessment of the performance of a local ventilation system", Build.Environ., 102, pp. 26-38 (2016).
5. Liu, Z., Liu, H., Rong, R., et al. "Effect of a circulating nurse walking on air flow and bacteria-carrying particles in the operating room: An experimental and numerical study", Build. Environ., 186, p. 107315 (2020).
6. De Lissovoy, G., Fraeman, K., Hutchins, V., et al. "Surgical site infection: incidence and impact on hospital utilization and treatment costs", Am. J. Infect. Control, 37(5), pp. 387-397 (2009).
7. Chow, T.-T. and Wang, J. "Dynamic simulation on impact of surgeon bending movement on bacteriacarrying particles distribution in operating theatre", Build. Environ., 57, pp. 68-80 (2012).
8. Andersson, A.E., Bergh, I., Karlsson, J., et al. "Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery", Am. J. Infect. Control, 40(8), pp. 750-755 (2012).
9. Darouiche, R.O., Green, D.M., Harrington, M.A., et al. "Association of airborne microorganisms in the operating room with implant infections: a randomized controlled trial", Infect. Control Hosp. Epidemiol., 38(1), pp. 3-10 (2017).
10. Stocks, G.W., Self, S.D., Thompson, B., et al. "Predicting bacterial populations based on airborne particulates: a study performed in nonlaminar  flow operating rooms during joint arthroplasty surgery", Am. J. Infect. Control, 38(3), pp. 199-204 (2010).
11. Stocks, G.W., O'connor, D.P., Self, S.D., et al. "Directed air flow to reduce airborne particulate and bacterial contamination in the surgical field during total hip arthroplasty", J. Arthroplasty, 26(5), pp. 771-776 (2011).
12. Cook, M., The Design Quality Manual: Improving Building Performance, John Wiley & Sons (2008).
13. Mcneill, J., Hertzberg, J., and Zhai, Z.J. "Experimental investigation of operating room air distribution in a full-scale laboratory chamber using particle image velocimetry and flow visualization", J. Flow Control, Meas. Visualization, 1(1), pp. 24-32 (2013).
14. Cao, G., Nilssen, A.M., Cheng, Z., et al. "Laminar air flow and mixing ventilation: Which is better for operating room airflow distribution near an orthopedic surgical patient?", Am. J. Infect. Control, 47(7), pp. 737-743 (2019).
15. Stacey, A. and Humphreys, H. "A UK historical perspective on operating theatre ventilation", J. Hosp. Infect., 52(2), pp. 77-80 (2002).
16. Whyte, W., Hodgson, R., and Tinkler, J. "The importance of airborne bacterial contamination of wounds", J. Hosp. Infect., 3(2), pp. 123-135 (1982).
17. Lidwell, O., Lowbury, E., Whyte, W., et al. "Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study", Br. Med. J., 285, pp. 10-14 (1982).
18. Bischoff, P., Kubilay, N.Z., Allegranzi, B., et al. "Effect of laminar air flow ventilation on surgical site infections: a systematic review and meta-analysis", Lancet Infect. Dis., 17(5), pp. 553-561 (2017).
19. Andersson, A.E., Petzold, M., Bergh, I., et al. "Comparison between mixed and laminar air flow systems in operating rooms and the influence of human factors: experiences from a Swedish orthopedic center", Am. J. Infect. Control, 42(6), pp. 665-669 (2014).
20. Wang, C., Holmberg, S., and Sadrizadeh, S. "Numerical study of temperature-controlled air flow in comparison with turbulent mixing and laminar airflow for operating room ventilation", Build. Environ., 144, pp. 45-56 (2018).
21. Alonso, J.S.J., Sanz-Tejedor, M., Arroyo, Y., et al. "Analysis and assessment of factors affecting air in flow from areas adjacent to operating rooms due to door opening and closing", Journal of Building Engineering, 49, p. 104109 (2022).
22. Gholami Motlagh, V. and Ahmadzadehtalatapeh, M. "Optimization of air distribution patterns by arrangements of air inlets and outlets: Case study of an operating room", J. Appl. Comput. Mech., 8(3), pp. 809-830 (2022).
23. Liu, Z., Yin, D., Hu, L., et al. "Bacteria-carrying particles diffusion in the operating room due to the interaction between human thermal plume and ventilation systems: An experimental-numerical simulation study", Energy Build., 270, p. 112277 (2022).
24. Fan, M., Cao, G., Pedersen, C., et al. "Suitability evaluation on laminar air flow and mixing airflow distribution strategies in operating rooms: A case study at St. Olavs Hospital", Build. Environ., 194, p. 107677 (2021).
25. Zhai, Z.J. and Osborne, A.L. "Simulation-based feasibility study of improved air conditioning systems for hospital operating room", Frontiers of Architectural Research, 2(4), pp. 468-475 (2013).
26. ASHRAE, ANSI Standard 170-2008 Ventilation of Health Care Facilities, American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc, Atlanta (2008).
27. Ning, M., Mengjie, S., Mingyin, C., et al. "Computational fluid dynamics (CFD) modelling of air flow field, mean age of air and CO2 distributions inside a bedroom with different heights of conditioned air supply outlet", Appl. Energy, 164, pp. 906-915 (2016).
28. Ufat, H., Kaynakli, O., Yamankaradeniz, N., et al. "Three-dimensional air distribution analysis of different outflow typed operating rooms at different inlet velocities and room temperatures", Adv. Mech. Eng., 9(7), pp. 1-12 (2017).
29. Deng, H.-Y., Feng, Z., and Cao, S.-J. "Influence of air change rates on indoor CO2 stratification in terms of Richardson number and vorticity", Build. Environ., 129, pp. 74-84 (2018).
30. Yau, Y. and Ding, L. "A case study on the air distribution in an operating room at Sarawak General Hospital Heart Centre (SGHHC) in Malaysia", Indoor Built Environ., 23(8), pp. 1129-1141 (2014).
31. Ding, L. and Yau, Y. "A study on the arrangement of air inlets in a Class 7 clean room", Building Serv. Eng. Res. Technol., 36(3), pp. 357-367 (2015).
32. Zheng, C., You, S., Zhang, H., et al. "Comparison of air-conditioning systems with bottom-supply and sidesupply modes in a typical office room", Appl. Energy, 227, pp. 304-311 (2018).
33. Liu, J., Wang, H., andWen, W. "Numerical simulation on a horizontal air flow for airborne particles control in hospital operating room", Build. Environ., 44(11), pp. 2284-2289 (2009).
34. Tung, Y.-C., Shih, Y.-C., and Hu, S.-C. "Numerical study on the dispersion of airborne contaminants from an isolation room in the case of door opening", Appl. Therm. Eng., 29(8-9), pp. 1544-1551 (2009).
35. ASHRAE, ANSI Standard 170-2013 Ventilation of Health Care Facilities, American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc, Atlanta (2013).
Volume 30, Issue 3
Transactions on Mechanical Engineering (B)
May and June 2023
Pages 1008-1026
  • Receive Date: 08 November 2021
  • Revise Date: 20 April 2022
  • Accept Date: 05 December 2022