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Journal of Orthopaedics and Traumatology
Published in: Journal of Orthopaedics and Traumatology 4/2011

Open Access 01-12-2011 | Original Article

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

Authors: D. Sossai, G. Dagnino, F. Sanguineti, F. Franchin

Published in: Journal of Orthopaedics and Traumatology | Issue 4/2011

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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/m3) 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/m3 without the LAF to 3.5 CFU/m3 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/m3 were recorded with the LAF (N = 6) unit and 30.8 CFU/m3 (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.
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Metadata
Title
Mobile laminar air flow screen for additional operating room ventilation: reduction of intraoperative bacterial contamination during total knee arthroplasty
Authors
D. Sossai
G. Dagnino
F. Sanguineti
F. Franchin
Publication date
01-12-2011
Publisher
Springer International Publishing
Published in
Journal of Orthopaedics and Traumatology / Issue 4/2011
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI
https://doi.org/10.1007/s10195-011-0168-5

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