274 - Lights, Airflow, Action: Unmasking Turbulence in the OR

Description: Maintaining optimal airflow in the operating room (OR) is a cornerstone of infection prevention and surgical team safety. While ventilation systems are designed to ensure laminar flow and effective removal of contaminants, surgical equipment, particularly overhead lights and patient warming devices, can unintentionally obstruct airflow and disrupt the sterile field. This study explores how surgical lighthead design and warming technology influence both downward laminar airflow and surgical smoke dispersal.

A simulated experimental study was conducted at the iEXCEL Simulation Center at the University of Nebraska Medical Center. Two scenarios were tested using a simulated OR environment equipped with HVAC regulation, sterile field setup, human cadaver tissue, and clinical role participants. Scenario A featured a surgical light with a cut-out airflow design combined with conductive patient warming (air-free). Scenario B utilized a conventional lighthead without airflow cut-outs and forced-air warming.

Airflow visualization above and below the lighthead was achieved using green laser tracers and smoke plumes (both simulated and from electrocautery). Results demonstrated that in Scenario A, airflow maintained its intended pattern across the surgical field, and smoke from the sterile site was efficiently cleared. In Scenario B, airflow was visibly obstructed above the surgical light, and smoke lingered at the sterile field due to upward air currents caused by forced-air warming and lack of venting in the lighthead design.

This study highlights how equipment choices in the OR can either support or impair air quality and sterility. Surgical lights with integrated airflow design features, in combination with air-neutral warming systems, were shown to preserve downward laminar airflow and reduce surgical smoke stagnation. These findings emphasize the importance of evaluating surgical equipment not just for functional performance, but also for their impact on environmental safety and infection control.

This poster will present airflow heatmaps, smoke dispersal imagery, and practical perioperative recommendations. The findings support the role of perioperative nurses in advocating for equipment configurations that protect the sterile field and align with AORN's guidelines for environmental safety and surgical smoke evacuation.