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Mobile laminar air flow screen for additional operating room ventilation: reduction of intraoperative bacterial contamination during total knee arthroplasty.

Title: Mobile laminar air flow screen for additional operating room ventilation: reduction of intraoperative bacterial contamination during total knee arthroplasty.
Authors: Sossai, D
Dagnino, G
Sanguineti, F
Franchin, F
Item Type: Journal Article
Abstract: BACKGROUND: Surgical site infections are important complications in orthopedic surgery. A mobile laminar air flow (LAF) screen could represent a useful addition to an operating room (OR) with conventional turbulent air ventilation (12.5 air changes/h), as it could decrease the bacterial count near the operating field. The purpose of this study was to evaluate LAF efficacy at reducing bacterial contamination in the surgical area during 34 total knee arthroplasties (TKAs). MATERIALS AND METHODS: The additional unit was used in 17 operations; the LAF was positioned beside the operating table between two of the surgeons, with the air flow directed towards the surgical area (wound). The whole team wore conventional OR clothing and the correct hygiene procedures and rituals were used. Bacterial air contamination (CFU/m(3)) was evaluated in the wound area in 17 operations with the LAF unit and 17 without the LAF unit. RESULTS: The LAF unit reduced the mean bacterial count in the wound area from 23.5 CFU/m(3) without the LAF to 3.5 CFU/m(3) with the LAF (P < 0.0001), which is below the suggested limit for an OR with ultraclean laminar ventilation. There were no significant differences in the mean bacterial count in the instrument table area: 28.6 CFU/m(3) were recorded with the LAF (N = 6) unit and 30.8 CFU/m(3) (N = 6) without the LAF unit (P = 0.631). During six operations with LAF and six without LAF, particle counts were performed and the number of 0.5 μm particles was analyzed. The particle counts decreased significantly when the LAF unit was used (P = 0.003). CONCLUSION: When a mobile LAF unit was added to the standard OR ventilation, bacterial contamination of the wound area significantly decreased to below the accepted level for an ultraclean OR, preventing SSI infections.
Issue Date: 10-Dec-2011
Date of Acceptance: 24-Oct-2011
URI: http://hdl.handle.net/10044/1/51424
DOI: https://dx.doi.org/10.1007/s10195-011-0168-5
ISSN: 1590-9921
Publisher: Springer
Start Page: 207
End Page: 211
Journal / Book Title: Journal of Orthopaedics and Traumatology
Volume: 12
Issue: 4
Copyright Statement: © The Author(s) 2011. This article is published with open access at Springerlink.com
Keywords: Air Microbiology
Arthroplasty, Replacement, Knee
Colony Count, Microbial
Environment, Controlled
Environmental Monitoring
Equipment Design
Humans
Hygiene
Infection Control
Operating Rooms
Surgical Wound Infection
Ventilation
Orthopedics
Publication Status: Published
Appears in Collections:Faculty of Engineering