Using color intensity projections to visualize air flow in operating theaters with the goal of reducing infections

Infection following neurosurgery is all too common. One possible source of infection is the transportation of dust and other contaminates into the open wound by airflow within the operating theatre. While many modern operating theatres have a filtered, uniform and gentle flow of air cascading down over the operating table from a large area fan in the ceiling, many obstacles might introduce turbulence into the laminar flow including lights, equipment and personal. Schlieren imaging - which is sensitive to small disturbances in the laminar flow such as breathing and turbulence caused by air warmed by a hand at body temperature – was used to image the air flow due to activities in an operating theatre. Color intensity projections (CIPs) were employed to reduce the workload of analyzing the large amount of video data. CIPs – which has been applied to images in angiography, 4D CT, nuclear medicine and astronomy – summarizes the changes over many gray scale images in a single color image in a way which most interpreters find intuitive. CIPs uses the hue, saturation and brightness of the color image to encode the summary. Imaging in an operating theatre showed substantial disruptions to the airflow due to equipment such as the lighting. When these disruptions are combined with such minor factors as heat from the hand, reversal of the preferred airflow patterns can occur. These reversals of preferred airflow patterns have the potential to transport contaminates into the open wound. Further study is required to understand both the frequency of the reversed airflow patterns and the impact they may have on infection rates.