{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:37:56Z","timestamp":1792723076263,"version":"4.5.0"},"reference-count":29,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100030785","name":"Getinge","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030785","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ajicjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Infection Control"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.ajic.2026.10.002","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:38:44Z","timestamp":1791329924000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of door openings, staff members and operation length on particle contamination and surgical site infections during acute and elective orthopedic implant surgery: An observational study"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7033-6807","authenticated-orcid":false,"given":"Frans","family":"St\u00e5lfelt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2821-4142","authenticated-orcid":false,"given":"Josefin","family":"Seth Caous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Malchau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Svensson Malchau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajic.2026.10.002_bib1","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1016\/j.arth.2024.01.032","article-title":"Direct hospital costs per case of periprosthetic hip and knee joint infections in Europe-A systematic review","volume":"39","author":"Szymski","year":"2024","journal-title":"J Arthroplast"},{"key":"10.1016\/j.ajic.2026.10.002_bib2","first-page":"857","article-title":"The burden of health care utilization, cost, and mortality associated with select surgical site infections","volume":"50","author":"Shambhu","year":"2024","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"10.1016\/j.ajic.2026.10.002_bib3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-009495","article-title":"Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery","volume":"5","author":"Moore","year":"2015","journal-title":"BMJ Open"},{"key":"10.1016\/j.ajic.2026.10.002_bib4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jhin.2022.04.014","article-title":"Patients' perspectives of healthcare-associated infection: 'you don't know what impacts it will have on your life","volume":"126","author":"Mitchell","year":"2022","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2026.10.002_bib5","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/0195-6701(82)90004-4","article-title":"The importance of airborne bacterial contamination of wounds","volume":"3","author":"Whyte","year":"1982","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2026.10.002_bib6","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/0195-6701(83)90041-5","article-title":"Airborne contamination of wounds in joint replacement operations: the relationship to sepsis rates","volume":"4","author":"Lidwell","year":"1983","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2026.10.002_bib7","doi-asserted-by":"crossref","DOI":"10.1016\/j.enbuild.2022.112277","article-title":"Bacteria-carrying particles diffusion in the operating room due to the interaction between human thermal plume and ventilation systems: an experimental-numerical simulation study","volume":"270","author":"Liu","year":"2022","journal-title":"Energy Build"},{"key":"10.1016\/j.ajic.2026.10.002_bib8","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.ajic.2021.12.021","article-title":"Important interventions in the operating room to prevent bacterial contamination and surgical site infections","volume":"50","author":"Wistrand","year":"2022","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2026.10.002_bib9","doi-asserted-by":"crossref","first-page":"645.e1","DOI":"10.1016\/j.aorn.2015.06.018","article-title":"Hand contamination, cross-transmission, and risk-associated behaviors: An observational study of team members in ORs","volume":"102","author":"Megeus","year":"2015","journal-title":"AORN J"},{"key":"10.1016\/j.ajic.2026.10.002_bib10","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.ajic.2011.09.015","article-title":"Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery","volume":"40","author":"Andersson","year":"2012","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2026.10.002_bib11","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1089\/sur.2020.361","article-title":"High number of door openings increases the bacterial load of the operating room","volume":"22","author":"Lansing","year":"2021","journal-title":"Surg Infect (Larchmt)"},{"key":"10.1016\/j.ajic.2026.10.002_bib12","doi-asserted-by":"crossref","first-page":"452","DOI":"10.3390\/ijerph17020452","article-title":"The influence of surgical staff behavior on air quality in a conventionally ventilated operating theatre during a simulated arthroplasty: a case study at the university hospital of parma","volume":"17","author":"Pasquarella","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"10.1016\/j.ajic.2026.10.002_bib13","unstructured":"SIS. Svenska institutet f\u00f6r standarder SIS-TS 39:2015. Microbiological cleanliness in the operating room \u2013 Preventing airborne contamination \u2013 Guidance and fundamental requirements."},{"key":"10.1016\/j.ajic.2026.10.002_bib14","unstructured":"DIN. Deutschen Instituts f\u00fcr Normung DIN 1946-4. Ventilation in buildings and rooms of health care 2018."},{"key":"10.1016\/j.ajic.2026.10.002_bib15","doi-asserted-by":"crossref","first-page":"8108","DOI":"10.3390\/app12168108","article-title":"Application of biofluorescent particle counters for real-time bioburden control in aseptic cleanroom manufacturing","volume":"12","author":"Behrens","year":"2022","journal-title":"Appl Sci"},{"key":"10.1016\/j.ajic.2026.10.002_bib16","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1111\/jam.12487","article-title":"Application of rapid microbiological methods for the risk assessment of controlled biopharmaceutical environments","volume":"116","author":"Sandle","year":"2014","journal-title":"J Appl Microbiol"},{"key":"10.1016\/j.ajic.2026.10.002_bib17","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ajic.2018.07.020","article-title":"Comparison of operating room air distribution systems using the environmental quality indicator method of dynamic simulated surgical procedures","volume":"47","author":"Wagner","year":"2019","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2026.10.002_bib18","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.ajic.2016.11.001","article-title":"Methodology for analyzing environmental quality indicators in a dynamic operating room environment","volume":"45","author":"Gormley","year":"2017","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2026.10.002_bib19","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/j.ajic.2023.05.004","article-title":"Can particle counting replace conventional surveillance for airborne bacterial contamination assessments? A systematic review using narrative synthesis","volume":"51","author":"Stalfelt","year":"2023","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2026.10.002_bib20","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1302\/2633-1462.64.BJO-2025-0002","article-title":"Deployment of real-time particle detection monitoring system in operating theatres for airborne contamination assessments: a methodological evaluation","volume":"6","author":"Stalfelt","year":"2025","journal-title":"Bone Jt Open"},{"key":"10.1016\/j.ajic.2026.10.002_bib21","first-page":"385","article-title":"The size distribution of airborne particles carrying micro-organisms","volume":"61","author":"Noble","year":"1963","journal-title":"J Hyg (Lond)"},{"key":"10.1016\/j.ajic.2026.10.002_bib22","doi-asserted-by":"crossref","DOI":"10.1017\/ash.2025.61","article-title":"Real-time biofluorescent particle counting compared to conventional air sampling for monitoring airborne contamination in orthopedic implant surgery","volume":"5","author":"Stalfelt","year":"2025","journal-title":"Antimicrob Steward Healthc Epidemiol"},{"key":"10.1016\/j.ajic.2026.10.002_bib23","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.artd.2017.05.003","article-title":"Infection burden in total hip and knee arthroplasties: an international registry-based perspective","volume":"3","author":"Springer","year":"2017","journal-title":"Arthroplast Today"},{"key":"10.1016\/j.ajic.2026.10.002_bib24","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1016\/j.ajic.2019.04.010","article-title":"Incidence and risk factors of surgical site infection after total knee arthroplasty: results of a retrospective cohort study","volume":"47","author":"Baier","year":"2019","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2026.10.002_bib25","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1186\/1471-2474-15-384","article-title":"Validation of reoperations due to infection in the Swedish hip arthroplasty register","volume":"15","author":"Lindgren","year":"2014","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.ajic.2026.10.002_bib26","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1007\/s11999-010-1688-7","article-title":"Current concepts for clean air and total joint arthroplasty: laminar airflow and ultraviolet radiation: a systematic review","volume":"469","author":"Evans","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.ajic.2026.10.002_bib27","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jhin.2021.08.009","article-title":"Influence of surgical team activity on airborne bacterial distribution in the operating room with a mixing ventilation system: a case study at St. Olavs Hospital","volume":"116","author":"Annaqeeb","year":"2021","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2026.10.002_bib28","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1017\/ice.2019.35","article-title":"Motion-capture system to assess intraoperative staff movements and door openings: impact on surrogates of the infectious risk in surgery","volume":"40","author":"Birgand","year":"2019","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.ajic.2026.10.002_bib29","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1089\/sur.2017.089","article-title":"Prolonged operative duration increases risk of surgical site infections: a systematic review","volume":"18","author":"Cheng","year":"2017","journal-title":"Surg Infect (Larchmt)"}],"container-title":["American Journal of Infection Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0196655326007364?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0196655326007364?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:50:10Z","timestamp":1792720210000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0196655326007364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":29,"alternative-id":["S0196655326007364"],"URL":"https:\/\/doi.org\/10.1016\/j.ajic.2026.10.002","relation":{},"ISSN":["0196-6553"],"issn-type":[{"value":"0196-6553","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Impact of door openings, staff members and operation length on particle contamination and surgical site infections during acute and elective orthopedic implant surgery: An observational study","name":"articletitle","label":"Article Title"},{"value":"American Journal of Infection Control","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajic.2026.10.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.","name":"copyright","label":"Copyright"}]}}