Operating theatre ventilation systems and microbial air contamination in total joint replacement surgery: results of the GISIO-ISChIA study
Operating theatre ventilation systems and microbial air contamination in total joint replacement surgery: results of the GISIO-ISChIA study
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DOI：
10.1016/j.jhin.2015.02.014
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发表时间：
2015-07-01
影响因子：
6.9
通讯作者：
Pasquarella, C.
中科院分区：
文献类型：
--
作者：
Agodi, A.;Auxilia, F.;Pasquarella, C.
背景：最近的研究表明，与湍流通气相比，单向气流通气的髋关节假体植入手术部位感染率更高。然而，这些研究没有测量手术室（OTs）的空气微生物质量，并假设它符合这种通风技术的推荐标准。目的：评价髋关节和膝关节置换术中空气微生物污染情况，并与关节置换术推荐值进行比较。方法：在单向、湍流和混合气流通风的28个试验室进行空气采样。采用被动采样法采集样品，测定微生物空气污染指数（IMA）。在一些外地办事处也进行了主动抽样。在抽样期间，记录了OT的平均人数和开门次数。结果：本研究共纳入1228例选择性假体手术（60.1%髋关节和39.9%膝关节）。在手术活动期间进行的单向气流通气OTs （U-OTs）和混合气流OTs （M-OTs）的被动采样中，58.9%和87.6%的IMA值分别为bbb20。在湍流气流OTs （T-OTs）和手术团队戴着Steri-Shield涡轮头盔（TH-OTs）进行的湍流气流OTs手术期间进行的采样中，8.6%和60%的IMA值
Background: Recent studies have shown a higher rate of surgical site infections in hip prosthesis implantation using unidirectional airflow ventilation compared with turbulent ventilation. However, these studies did not measure the air microbial quality of operating theatres (OTs), and assumed it to be compliant with the recommended standards for this ventilation technique.Aim: To evaluate airborne microbial contamination in OTs during hip and knee replacement surgery, and compare the findings with values recommended for joint replacement surgery.Methods: Air samplings were performed in 28 OTs supplied with unidirectional, turbulent and mixed airflow ventilation. Samples were collected using passive sampling to determine the index of microbial air contamination (IMA). Active sampling was also performed in some of the OTs. The average number of people in the OT and the number of door openings during the sampling period were recorded.Findings: In total, 1228 elective prosthesis procedures (60.1% hip and 39.9% knee) were included in this study. Of passive samplings performed during surgical activity in unidirectional airflow ventilation OTs (U-OTs) and mixed airflow OTs (M-OTs), 58.9% and 87.6% had IMA values >2, respectively. Of samplings performed during surgical activity in turbulent airflow OTs (T-OTs) and in turbulent airflow OTs with the surgical team wearing Steri-Shield Turbo Helmets (TH-OTs), 8.6% and 60% had IMA values