'Excising Infection in the Surgical Environment [ExISE]' is an Arts and Humanities Research Council (AHRC) research project within the major cross UK Research Council initiative 'Tackling Antimicrobial Resistance' [AMR].

 

In my role as an interdisciplinary coordinator at University of Cambridge based in the Veterinary school and Medical School, I identified a grant and met with researchers in different departments and schools to connect them and identify interest in forming a consortium to prepare a grant bid. A perhaps unusually interdisciplinary team of academics was formed; including infectious diseases, pathogen transmission, architecture, history and philosophy of science, fluid mechanics and history of art . Through a series of meetings, a proposal was developed to introduce a design perspective to AMR research by investigating the physical environments for surgery. Project Partners were expanded to include RCS Research Fellows and Fellows, the NHS Sustainable Development Unit, the Institute of Hospital Engineering and Estate Management, NHSi, leading engineering and design practices Happold and Gensler and the international hospital contractor Skanska.

 

The project built on the scoping work of the Principle Investigator's NHS funded 'Bloody Rooms' project which enabled a basic understanding of the behaviour of pathogens within airflows in a hospital room. The aim of the research is to better understand the behavior of air flow and pathogens in operating theatres,  aiming to eliminate aerosol related Surgical Site Infections [SSI] in operating theatres [OT] through re-examining the evidence. The work may lead to the reinvention of the physical surgical environment to a greater or lesser degree. Designing out transmission routes for SSI could ultimately reduce the reactive use of antibiotics post-surgery and hence their contribution to AMR.  In 2020, in response to the extreme pressures imposed by COVID-19 on hospital facilities globally, healthcare authorities are temporarily adapting any available large open halls to increase bed space capacity for housing infected patients. The project was therefore widened into researching simple, low-cost ventilation designs and configuration solutions to limit infection dispersal of Covid-19 in airborne particles and help to make rapid conversions/adaptations of buildings, safer for patients and healthcare staff.

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Prof. Alan Short (PI) cas64@cam.ac.uk University of Cambridge (UoC) Department of Architecture (CID)