Journal of the Architectural Institute of Korea (대한건축학회논문집)

Architectural Institute of Korea (대한건축학회)
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Alteration of Supply and Exhaust Diffusers in a Negative Pressure Operating Room to Prevent Secondary Infection of Surgical Team

의료진 2차 감염 예방을 위한 음압수술실의 급배기구 변경

  • Song, Kyung-Seok (Facility Management Division, Myongji Hospital) ;
  • Kim, Sean Hay (School of Architecture, Seoul National University of Science and Technology)
  • 송경석 (명지병원 시설관리팀) ;
  • 김선혜 (서울과학기술대학교 건축공학과)
  • Received : 2022.02.14
  • Accepted : 2022.04.13
  • Published : 2022.04.30
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Abstract

Accompanying patient safety, the surgical team needs protection from secondary infection particularly when an infected patient has surgery in a negative pressure room. Even if the room is excessively depressurized, cases of surgical teams acquiring secondary infections have increased. This study aims to analyze the feasibility of altering the supply and exhaust diffusers in negative pressure rooms, in terms of aperture area, diffuser type, and location of exhausts. A CFD pre-analysis was first performed to comprehend the alteration scenarios; field experiments were performed in a real negative pressure room of Myongji Hospital in Korea. This study found that replacing the existing perforated SA diffuser with a register type diffuser directly provided fresher air to a surgical team and significantly reduced the exposure of secondary infection. Additionally, keeping only two exhausts near a patient's feet, rather than four at each corner, secured more apparent air flow patterns within the negative pressure room. The combination of the two alteration scenarios were effective in reducing the spread of infectious particles emitting from a patient while enabling a faster discharge of the presumably infected air.

Keywords

Acknowledgement

This study was supported by the Research Program funded by the Seoul National University of Science and Technology.

References

  1. Agirman, A., Cetin, Y. E., Avci, M., & Aydin, O. (2020). Effect of air exhaust location on surgical site particle distribution in an operating room, Building Simulation, 13, 979-988. https://doi.org/10.1007/s12273-020-0642-1
  2. Agirman, A., Cetin, Y. E., Avci, M., & Aydin, O. (2021). Effect of laminar airflow unit diffuser size on pathogen particle distribution in an operating room, Science and Technology for the Built Environment, 27(4), 402-413. https://doi.org/10.1080/23744731.2020.1816405
  3. ASHRAE. (2013). Standard 170-2013; Ventilation of Health Care Facilities, Atlanta: American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc
  4. Cobalt. (n.d.). Oracle, Retrieved Feb. 10th, 2022 from https://www.cobalt.re.kr/oracle-kor
  5. Chow, T.T., & Yang, X.Y. (2005). Ventilation performance in the operating theatre against airorne infection: numerical study on an ultra-clean system, Journal of Hospital Infection, 59, 138-147. https://doi.org/10.1016/j.jhin.2004.09.006
  6. Drager Inc. (n.d.). Drager Flow Check. Retrieved Feb. 10th, 2022 from https://www.draeger.com/en-us_us/Products/Flow-Check
  7. FGI. (2018). Guidelines for Design and Construction of Hospitals, Retrieved Feb. 10th, 2022 from www.fgiguidelines.org/guidelines/2018-fgi-guidelines
  8. He, G., Yang, X., & Srebric, J. (2005). Removal of contaminants released from room surfaces by displacement and mixing ventilation: modeling and validation, Indoor Air, 15(5), 367. https://doi.org/10.1111/j.1600-0668.2005.00383.x
  9. HEAJ. (2013). Design and Management of Hospital Air-conditioning Guideline HEAS-02-2013, Retrieved Feb. 10th, 2022 from https://www.heaj.org/pdf/guideline_kuchou_index.pdf
  10. Jung, M. J., & Hong, J. K. (2019). A numerical study on cough particle dispersion and deposition according to the location of exhaust air diffuser in airborne infection isolation room, Korea Journal of Air-Conditioning and Refrigeration Engineering, 31(12), 559-567. https://doi.org/10.6110/KJACR.2019.31.12.559
  11. Kwon, S. J., Joo Y. C., & Kim, C. S. (2002). A study on the diffuser location for the reduction of airborne infection in operation room, Journal of the Korea Institute of Healthcare Architecture, 8(1), 7-12.
  12. KDCA (Korea Disease Control and Prevention Agency). (2019). Operation and Management Guideline for National Patient Isolation Units, Retrieved Feb. 10th, 2022 from https://www.kdca.go.kr/board/board.es?mid=a20507020000&bid=0019
  13. Lee, B. U. (2020). Minimum sizes of respiratory particles carrying SARS-CoV-2 and the possibility of aerosol generation. International Journal of Environmental Research and Public Health, 17(19), 6960. https://doi.org/10.3390/ijerph17196960
  14. Siemens PLM. (n.d.). Simcenter STAR-CCM+. Retrieved Feb. 10th, 2022 from https://www.plm.automation.siemens.com/global/en/products/simcenter/STAR-CCM.html.
  15. USCDC. (2003). Guidelines for Environmental Infection Control in Health-care Facilities. Retrieved Feb. 10th, 2022 from https://www.cdc.gov/infectioncontrol/pdf/guidelines/environmental-guidelines-P.pdf.
  16. USCDC. (2005). Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-care Settings. MMWR. Retrieved Feb. 10th, 2022 from https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm
  17. Xue, K., Cao, G., Liu, M., Zhang, Y., Pedersen, C., Mathisen, H. M., ... & Skogas, J. G. (2020). Experimental study on the effect of exhaust airflows on the surgical environment in an operating room with mixing ventilation, Journal of Building Engineering, 32, 101837. https://doi.org/10.1016/j.jobe.2020.101837
  18. Yang, S., Lee, G. W. M., Chen, C.-M., Wu, C.-C., & Yu, K.-P. (2007). The size and concentration of droplets generated by coughing in human subjects, Journal of Aerosol Medicine, 20(4), pp. 484-494. https://doi.org/10.1089/jam.2007.0610