Cherwell develops bespoke new product to support air quality audit in UCA operating theatres

New peel apart settle plate pack developed by Cherwell to support UK national study on relationship between microbiological air quality of operating theatres and infection rates.

Cherwell, cleanroom microbiology solutions expert, has developed a new peel apart pack settle plate product to support a UK national study investigating the relationship between 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 ultra clean air (UCA) operating theatres while actually in use for surgery.

Despite the well-documented relationship between microbiological air quality and deep infection rates, it is not routine to monitor operating theatres when in use. This is because slit samplers are traditionally used to test air quality by volumetric counting, but these are labour-intensive, requiring trained individuals and not practical 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, Mr. Andrew Thomas, The Royal Orthopaedic Hospital, Birmingham, explained, “Regular plate packs must be opened in a completely aseptic way using sterile scissors, and that is 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 that is dispensed to the scrub nurse by the circulating staff, but this wasn’t available on the market,” continued Andrew.

Cherwell’s Bespoke Product team supported Andrew and the JOINTCASE audit through the company’s New Product Request Process. Andrew said, “We approached Cherwell who took a keen interest in our problem and worked hard to deliver the solution. Other well-known multinational companies working in the area were simply not interested in a relatively small problem. Cherwell’s team, recognised that making the peel apart packs would be a great contribution, and actually not terribly difficult to deliver.”

The Joint Orthopaedics and Infectious diseases National Theatre Clean Air Services Evaluation (JOINTCASE) is an ongoing national, multicentre, prospective audit. All elective orthopaedic units in the UK are encouraged to participate in this 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.

In addition to its standard range of Redipor® media products, instrument accessories and packaging, Cherwell also offers a fully bespoke service for any aspect of environmental monitoring programs. Cherwell’s new peel apart packs of Redipor® tryptone soy agar (TSA) settle plates, developed initially as a bespoke product for the JOINTCASE study, are now available for purchase as packs of 10.