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Laminar airflow decreases microbial air contamination compared with turbulent ventilated operating theatres during live total joint arthroplasty: a nationwide survey

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@article{48c922bb31e64c64858112be4d9b2245,
title = "Laminar airflow decreases microbial air contamination compared with turbulent ventilated operating theatres during live total joint arthroplasty: a nationwide survey",
abstract = "BACKGROUND: Preventing surgical site infections and prosthetic joint infections is crucial for patient safety after total joint arthroplasty. Microbial air contamination has been suggested as a risk factor. Therefore, the ventilation system that will reduce air contamination most effectively in operating theatres (OTs) has been discussed.AIM: To determine whether laminar airflow (LAF) ventilation is superior to turbulent airflow (TAF) ventilation by looking at the colony forming units (cfu) count during live total hip and knee arthroplasties. Furthermore, to explore whether the number of OT personnel, door and cabinet lock openings and technical parameters of the ventilation systems have an impact on the number of cfu.METHODS: Active air sampling and passive sedimented bacterial load were performed in 17 OTs, equipped with either LAF or TAF ventilation, during 51 live surgeries while observations were noted.FINDINGS: LAF OTs reduced cfu counts compared with TAF OTs during live surgery (P<0.001). All LAF OTs provided ultraclean air whereas TAF had nine procedures exceeding the threshold of 10 cfu/m 3. Door and cabinet lock openings and number of personnel did not influence the cfu count, while it decreased with increasing volume and total air change per hour (P<0.05). CONCLUSION: All LAF OTs had cfu counts within recommendations and provided lower cfu counts compared with TAF OTs. The number of OT personnel and total openings did not have an influence on cfu counts. Increased volume of the OT and total air change per hour showed a decrease in active cfu counts.",
keywords = "Air quality, Colony forming units, Laminar airflow, Microbial air contamination, Operating theatre, Turbulent airflow, Air Microbiology, Humans, Bacterial Load, Colony Count, Microbial, Surgical Wound Infection, Operating Rooms, Arthroplasty, Replacement, Knee, Ventilation",
author = "Knudsen, {R. J.} and Knudsen, {S. M.N.} and T. Nymark and T. Anstensrud and Jensen, {E. T.} and {La Mia Malekzadeh}, {M. J.} and S. Overgaard",
note = "Funding Information: This study was funded by ELFORSK, part of the Danish Energy Agency . Publisher Copyright: {\textcopyright} 2021 The Healthcare Infection Society Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jul,
doi = "10.1016/j.jhin.2021.04.019",
language = "English",
volume = "113",
pages = "65--70",
journal = "Journal of Hospital Infection",
issn = "0195-6701",
publisher = "W.B./Saunders Co. Ltd",

}

RIS

TY - JOUR

T1 - Laminar airflow decreases microbial air contamination compared with turbulent ventilated operating theatres during live total joint arthroplasty

T2 - a nationwide survey

AU - Knudsen, R. J.

AU - Knudsen, S. M.N.

AU - Nymark, T.

AU - Anstensrud, T.

AU - Jensen, E. T.

AU - La Mia Malekzadeh, M. J.

AU - Overgaard, S.

N1 - Funding Information: This study was funded by ELFORSK, part of the Danish Energy Agency . Publisher Copyright: © 2021 The Healthcare Infection Society Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/7

Y1 - 2021/7

N2 - BACKGROUND: Preventing surgical site infections and prosthetic joint infections is crucial for patient safety after total joint arthroplasty. Microbial air contamination has been suggested as a risk factor. Therefore, the ventilation system that will reduce air contamination most effectively in operating theatres (OTs) has been discussed.AIM: To determine whether laminar airflow (LAF) ventilation is superior to turbulent airflow (TAF) ventilation by looking at the colony forming units (cfu) count during live total hip and knee arthroplasties. Furthermore, to explore whether the number of OT personnel, door and cabinet lock openings and technical parameters of the ventilation systems have an impact on the number of cfu.METHODS: Active air sampling and passive sedimented bacterial load were performed in 17 OTs, equipped with either LAF or TAF ventilation, during 51 live surgeries while observations were noted.FINDINGS: LAF OTs reduced cfu counts compared with TAF OTs during live surgery (P<0.001). All LAF OTs provided ultraclean air whereas TAF had nine procedures exceeding the threshold of 10 cfu/m 3. Door and cabinet lock openings and number of personnel did not influence the cfu count, while it decreased with increasing volume and total air change per hour (P<0.05). CONCLUSION: All LAF OTs had cfu counts within recommendations and provided lower cfu counts compared with TAF OTs. The number of OT personnel and total openings did not have an influence on cfu counts. Increased volume of the OT and total air change per hour showed a decrease in active cfu counts.

AB - BACKGROUND: Preventing surgical site infections and prosthetic joint infections is crucial for patient safety after total joint arthroplasty. Microbial air contamination has been suggested as a risk factor. Therefore, the ventilation system that will reduce air contamination most effectively in operating theatres (OTs) has been discussed.AIM: To determine whether laminar airflow (LAF) ventilation is superior to turbulent airflow (TAF) ventilation by looking at the colony forming units (cfu) count during live total hip and knee arthroplasties. Furthermore, to explore whether the number of OT personnel, door and cabinet lock openings and technical parameters of the ventilation systems have an impact on the number of cfu.METHODS: Active air sampling and passive sedimented bacterial load were performed in 17 OTs, equipped with either LAF or TAF ventilation, during 51 live surgeries while observations were noted.FINDINGS: LAF OTs reduced cfu counts compared with TAF OTs during live surgery (P<0.001). All LAF OTs provided ultraclean air whereas TAF had nine procedures exceeding the threshold of 10 cfu/m 3. Door and cabinet lock openings and number of personnel did not influence the cfu count, while it decreased with increasing volume and total air change per hour (P<0.05). CONCLUSION: All LAF OTs had cfu counts within recommendations and provided lower cfu counts compared with TAF OTs. The number of OT personnel and total openings did not have an influence on cfu counts. Increased volume of the OT and total air change per hour showed a decrease in active cfu counts.

KW - Air quality

KW - Colony forming units

KW - Laminar airflow

KW - Microbial air contamination

KW - Operating theatre

KW - Turbulent airflow

KW - Air Microbiology

KW - Humans

KW - Bacterial Load

KW - Colony Count, Microbial

KW - Surgical Wound Infection

KW - Operating Rooms

KW - Arthroplasty, Replacement, Knee

KW - Ventilation

UR - http://www.scopus.com/inward/record.url?scp=85106391058&partnerID=8YFLogxK

U2 - 10.1016/j.jhin.2021.04.019

DO - 10.1016/j.jhin.2021.04.019

M3 - Journal article

C2 - 33932555

AN - SCOPUS:85106391058

VL - 113

SP - 65

EP - 70

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

SN - 0195-6701

ER -

ID: 66310490