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National study requires new peel apart packs to assess relationship between<br />

microbiological quality of operating theatre air and infection rate<br />

Cherwell develops bespoke new<br />

product to support air quality<br />

audit in UCA operating theatres<br />

Cherwell, cleanroom microbiology solutions<br />

expert, has developed a new peel apart pack<br />

settle plate product to support a UK national<br />

study investigating the relationship between<br />

microbiological quality of operating<br />

theatre air and infection rate. Supported<br />

by NHS England, the UK Health Security<br />

Agency and British Orthopaedic Association,<br />

the JOINTCASE audit aims to check the<br />

air quality of ultra clean air (UCA) operating<br />

theatres while actually in use for surgery.<br />

Despite the well-documented relationship<br />

between microbiological air quality and<br />

deep infection rates, it is not routine to monitor<br />

operating theatres when in use. This is<br />

because slit samplers are traditionally used<br />

to test air quality by volumetric counting, but<br />

these are labour-intensive, requiring trained<br />

individuals and not practical for routine audits.<br />

The study management group noted<br />

settle plate counting to be a simpler methodology<br />

and its relationship with volumetric<br />

counting well established.<br />

Conducted jointly by local orthopaedic<br />

and microbiology/infectious disease departments<br />

in elective orthopaedic units nationwide,<br />

the audit now uses a settle plate<br />

based technique. For this, packs of 10 microbiology<br />

plates, which can be simply peeled<br />

apart aseptically for easy sterile dispensing<br />

onto surgical instrument trolleys and next<br />

to the wound, were specially developed by<br />

Cherwell. To further minimise contamination<br />

risk, during transfer for incubation after<br />

exposure, the plates can be secured with<br />

sterile elastic bands which are also supplied<br />

within the packs.<br />

The new peel apart packs were required<br />

as settle plates are generally packed double<br />

or triple wrapped and sterilised for laboratory<br />

or cleanroom use, which is not sufficient<br />

during surgery in an operating theatre.<br />

Study lead and orthopaedic surgeon, Mr.<br />

Andrew Thomas, The Royal Orthopaedic<br />

Hospital, Birmingham, explained, “Regular<br />

plate packs must be opened in a completely<br />

New peel apart settle plate pack developed by Cherwell to support UK national study on<br />

relationship between microbiological air quality of operating theatres and infection rates.<br />

aseptic way using sterile scissors, and that<br />

is an additional task for the scrub person. It<br />

distracts them and there is a risk of de-sterilising<br />

the outside of the settle plates.”<br />

“The logical answer was to have a peel<br />

apart pack, which can be dispensed onto the<br />

sterile instrument trolley, just like any other<br />

piece of equipment that is dispensed to the<br />

scrub nurse by the circulating staff, but this<br />

wasn’t available on the market,” continued<br />

Andrew.<br />

Cherwell’s Bespoke Product team supported<br />

Andrew and the JOINTCASE audit<br />

through the company’s New Product Request<br />

Process. Andrew said, “We approached<br />

Cherwell who took a keen interest in<br />

our problem and worked hard to deliver the<br />

solution. Other well-known multinational<br />

companies working in the area were simply<br />

not interested in a relatively small problem.<br />

Cherwell’s team, recognised that making<br />

the peel apart packs would be a great contribution,<br />

and actually not terribly difficult<br />

to deliver.”<br />

The Joint Orthopaedics and Infectious diseases<br />

National Theatre Clean Air Services<br />

Evaluation (JOINTCASE) is an ongoing<br />

national, multicentre, prospective audit.<br />

All elective orthopaedic units in the UK<br />

are encouraged to participate in this study.<br />

This includes major elective centres, tertiary<br />

units, and district general hospitals. Initially,<br />

the audit will focus on UCA theatres used<br />

for joint replacement surgery in the UK.<br />

In addition to its standard range of Redipor®<br />

media products, instrument accessories<br />

and packaging, Cherwell also offers a<br />

fully bespoke service for any aspect of environmental<br />

monitoring programs. Cherwell’s<br />

new peel apart packs of Redipor® tryptone<br />

soy agar (TSA) settle plates, developed initially<br />

as a bespoke product for the JOINTCA-<br />

SE study, are now available for purchase as<br />

packs of 10.<br />

Cherwell Laboratories Ltd<br />

OX26 4XB BICESTER<br />

Vereinigtes Königreich<br />

www.reinraum.de | www.cleanroom-online.com NEWSLETTER | Edition <strong>EN</strong> <strong>07</strong>-<strong>2024</strong><br />

page 15/28

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