The Use of a 405-nm Blue Light System in a Neurosurgical Department as an Adjunct for Lowering Environmental Contamination and Perioperative Infections: Results from a Prospective Observational Cohort Study

BACKGROUND AND OBJECTIVES:No data exist regarding the potential impact of a blue light system on environmental colonization and perioperative infections in neurosurgery. Main objective of this work was to analyze the clinical efficacy of a novel blue light system on the rate of environmental colonization and perioperative infections in a neurosurgical department.METHODS:In this observational prospective cohort study, we prospectively enrolled all head/spine neurosurgical patients (January-December 2023) at a third-level referral center in Italy. Patients were followed after surgery in two separate neurosurgical wards, following normal institutional protocol. One ward was previously equipped with the INTEGRALIS® (Artemide®) blue light (405 nm) as the primary light source and the other with common neon lights. We longitudinally assessed both wards for environmental colonization (contact plates, contact swabs, and air samplings) and for the rate of clinically manifest perioperative infections (primary end points). A dedicated questionnaire evaluated patient and health professional satisfaction with the new luminous system (secondary end point).RESULTS:Nine hundred seventy-seven patients (5765 days of hospitalization, DoH) and 1252 patients (6332 DoH) were followed, respectively, in blue light and neon wards. From an environmental perspective, a higher incidence of plates with a CFU level below 25 CFU/plate threshold was found in blue light ward compared with the neon ward at 1 month (46.2% vs 33.3%, P =.26) and, significantly, at 5 months (68.3% vs 42.3%, P =.001). No difference was observed considering cultures executed at 1 year (P =.17). On a clinical perspective, the overall number of infections/10000 DoH was lower in blue light ward (79.0 vs 45.1, P =.02, CI 95% 1.1-2.9), with a significantly reduced rate of wound infections in respect to neon ward (10.4 vs 41.1, P =.001, CI 95% 1.6-11.7).CONCLUSION:Blue light systems may in a surgical setting may help in lowering bacterial colonization and clinically manifest infections.