Effectiveness of reducing bacterial air contamination when covering sterile goods in the operating room setting: a systematic review and meta-analysis.

Background: Postoperative surgical site infection is a serious problem. Coverage of sterile goods may be important to protect the goods from bacterial air contamination while awaiting surgery.

Aim: To evaluate the effectiveness of this practice in a systematic review covering five databases using search terms related to bacterial contamination in the operating room and on surgical instruments.

Methods: MEDLINE, Cochrane, CINAHL, Embase, and Web of Science databases were searched from inception to February 13, 2023, for randomized and non-randomized controlled studies of covering interventions conducted in the operating room setting. The outcome was bacterial air contamination measured as colony-forming units, and a meta-analysis was performed in separate time periods of coverage. This systematic review and meta-analysis is reported according to the PRISMA statement, and the protocol was prospectively registered in PROSPERO (CRD42022323113). The time points ranged from 30 min to 24 h.

Findings: The results showed that covering sterile goods significantly prevented bacterial air contamination as compared to uncovered goods. The meta-analysis was in favour of covering sterile goods for protection from bacterial air contamination, and showed an effect size Z of 4.76 (P<0.00001; confidence interval: -1.94 to -0.81). The heterogeneity analysis showed a heterogeneity of 83%.

Conclusion: No negative effects regarding bacterial contamination were found, and so we conclude that protection with a sterile cover decreases bacterial air contamination of sterile goods while waiting for surgery to start.