Iranian researcher Sasan Sadrizadeh, at KTH Royal Institute of Technology in Sweden, in collaboration with an international research team, have published promising results on a new design of hospital operating room ventilation by using the most advanced super computers to do mathematical calculation in the field of fluid mechanics to predict airflow field and contaminant dispersion in operating rooms. This can reduce the surgical site infections among the patients undergoing surgical intervention. As many patients died annually due to this type of infections, it is a hope to save the lives of patients who are prone to air-borne infection in hospitals.
What follows is Mr. Sadrizadeh’s interview with Mehr News Agency on their recent breakthrough on what he calls a ‘ticking time bomb’:
You have made a breakthrough by introducing a new method to reduce bacterial contamination in the operating room. Can you explain in detail and in layman’s terms the purpose and findings of your research, as well as its significance and application? Where did you get the inspiration for your project?
As you know, the history of surgery is nearly as old as the human race and surgical team were struggling to overcome the three principal obstacles of infection, pain and bleeding. For patients undergoing any surgical intervention, there is always a risk that they will develop some kind of postoperative complication. One of the most challenging postoperative complication can be surgical site infection. This type of infection may extend within the surgical wound margin after the operating. These infections can be either superficial involving the skin only or they can be more serious and involve tissues, organs and implanted material. Surgical infections are very case-dependent and some patients may be at higher risk of developing postoperative infections due to factors such as age, underlying medical conditions, invasiveness of the surgery and duration of the procedure.
Surgical infection can contribute to higher rates of patient morbidity and mortality, loss of productivity, increased hospitalization time and patient dissatisfaction. These infections can also impose a substantial economic burden on both healthcare provider and the patient.
The infection risk of patients is highly correlated with the concentration of viable airborne bacteria within the operating room environment. It is a general knowledge among the experts in the area of infection control that staff working in the OR are the main source of airborne bacteria. Surgical team members disseminate pathogenic organisms into their surrounding environment. A person releases about 10,000 skin scales per minute during walking activities, however a small fraction of them is enough to initiate a severe infection.
It has been reported that Staphylococcus aureus is the most commonly implicated bacterial pathogen found in the surgical rooms and is one of the important causes of skin and soft tissue infections. Recently, the increasing rate of antimicrobial drug resistance has been a matter of great concern, as many types of Staph bacteria have now become resistant to many antibiotics. The danger posed by growing resistance to antibiotics has been described a global threat, more dangerous than climate change, a “ticking time bomb” that should be ranked alongside terrorism on the list of threats to the human race.
Prevention and treatment of surgical infection is usually managed by:
Drug therapy: Antibiotics
Dilution and evacuation of infectious particles: Using an efficient OR ventilation system
Source Control: Increasing the performance of staff clothing in preventing the shedding of bacteria to the air, Reducing the number and activity of staff in the operating rooms and Work practice improvement during a given surgical activity.
In our research, we mainly focused on ventilation efficiency and source control. We used the most advanced super computers to do mathematical calculation in the field of fluid mechanics to predict airflow field and contaminant dispersion in operating rooms. We try to optimize and improve the ventilation efficiency to provide the lowest possible airborne bacteria concentration and thus a reduced rate of surgical site infections. Another part of this research was focused on performance of surgical clothing systems and work practice improvement of surgical team members.
This is how different air flows out in an OR with 10 people moving about.
What were the particular obstacles or difficulties in your research? How did you overcome them?
Hospital operating rooms are among the most critical working environment and research in this area would be very difficult. Performing any research study during a given surgical procedure may involve several ethical and logistical considerations, and frequently cannot be repeated. The complexity of working environment is another obstacle that makes experimental investigation very difficult and expensive.
Mutual understanding among engineers and surgical staff is a key to making for an easier and more straightforward further development in ventilation principles and infection control. Currently, there is large gap among the medical and engineering fields and these two areas can barely collaborate.
The control of airborne particles in hospitals and operating room environments requires comprehensive knowledge about the source and transport mechanism of the bacteria-carrying particles. The role of airflow streams as a vehicle for airborne particles should be well understood.
How long will it take for your findings to become applicable in the hospitals and save lives of thousands?
Several assessment based on finding of this research is now experimentally put in practice in sham operations. The area of surgery is that much complicated that any small error can end up to a catastrophe and thus it should be well evaluated before using in real surgeries. Therefore more research is needed until it becomes applicable in operating rooms.
In what direction do you see your research going in the future?
We work on some advance models of hybrid ventilations to have the benefit of several airflow principals to have the most efficient airflow pattern. Recently many hospitals and industrial companies, active in this research area, show interest to this project and we hopefully can have a broad interdisciplinary collaboration with experts in different area to fasten the research progress.
Beside this recent scientific accomplishment, what other projects of yours managed to receive such wide-spread recognition?
We work in another method to capture, disable and evacuate the viable particles from the surgical area. This method work independently from operating room ventilation systems and it can be much more efficient than the currently used methods of infection control.
Will you bring back the results of your research to Iran and apply them to Iranian hospitals? Do you have any plans for joint cooperation with Iranian scientists in this regard?
It is hard to say in this stage!
Sasan Sadrizadeh is a researcher in Fluid and Climate Technology Division. His research is focused on Design of Hospital Operating Room Ventilation using Computational Fluid Dynamics technique. Sasan received a PhD in Applied Fluid Mechanics in 2016 from KTH Royal Institute of Technology. He graduated in 2012 from Linköping University with a Master of Science in Applied Thermodynamics and Fluid Mechanics. He is primarily interested in studying the Fluid–structure interaction, Fluid-Particle dynamics, the physics and chemistry of indoor air pollution, Heat and Mass transfer using various numerical methods.
Interview by: Marjohn Sheikhi