Influence of laminar airflow on prosthetic joint infections: A systematic review

Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, Germany.
The Journal of hospital infection (Impact Factor: 2.54). 05/2012; 81(2):73-8. DOI: 10.1016/j.jhin.2012.04.008
Source: PubMed


Many hospitals use ultraclean ventilation (UVC), also known as laminar airflow systems (LAF), in their operating rooms to decrease rates of surgical site infections (SSIs). However, the evidence for these systems is limited and the additional expenses for LAF are substantial.
To determine the effectiveness of LAF to decrease SSI rates following hip and knee prosthesis.
Systematic review of cohort studies investigating the influence of LAF on SSIs following hip and knee prosthesis published during the last 10 years.
Four cohort studies using the endpoint severe SSI following knee prosthesis and four studies following hip prosthesis were included. No individual study showed a significant benefit for LAF following knee prosthesis but one small study showed a significant benefit following hip prosthesis. However, one individual study showed significantly higher severe SSI rates following knee prosthesis and three studies significantly higher SSI rates following hip prosthesis under LAF conditions. The summary odds ratio was 1.36 (95% confidence interval: 1.06-1.74) for knee prosthesis and 1.71 (1.21-2.41) for hip prosthesis.
It would be a waste of resources to establish new operating rooms with LAF, and questionable as to whether LAF systems in existing operating rooms should be replaced by conventional ventilation systems.

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Available from: Christian Brandt, Sep 04, 2014
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    • "An extensive multicenter study was conducted which showed no benefit to ultraviolet light use [114]. Laminar-flow air-handling systems have been used, but only have testimonial evidence to support their use even in clean operations [115]. Restricting traffic in and out of the operating room reduces the generation of air currents which may well reduce air-borne bacteria from the floor [116]. "
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