Whyte, W. and Lytsy, B. (2019) Ultraclean air systems and the claim that laminar airflow systems fail to prevent deep infections after total joint arthroplasty. Journal of Hospital Infection, 103(1), e9-e15. (doi: 10.1016/j.jhin.2019.04.021) (PMID:31059724)
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Abstract
The World Health Organization published guidelines in 2016 for preventing surgical site infections. The guidelines contained a conditional recommendation that laminar airflow (LAF) ventilation systems should not be used to reduce the risk of infection after total joint arthroplasty (TJA). This recommendation was largely based on a systematic review and meta-analysis of information from hospital infection surveillance registries. The recommendation contradicts information published in earlier major studies carried out by Charnley and the UK Medical Research Council (MRC). The first aim of this article is to revisit and explain the MRC study, and reply to criticisms of it. The second aim is to suggest reasons why some recent studies have failed to demonstrate that ultraclean air (UCA) systems reduce deep joint infection after TJA. It demonstrates that if a UCA system establishes average airborne concentrations of microbe-carrying particles (MCPs) <10/m , and preferably <1/m , then deep joint infection after TJA will be lower than in conventionally ventilated operating theatres.
| Item Type: | Articles |
|---|---|
| Keywords: | Laminar airflow (LAF), surgical infections, total joint arthroplasty, ultraclean air. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Whyte, Dr William |
| Authors: | Whyte, W., and Lytsy, B. |
| College/School: | College of Science and Engineering > School of Engineering |
| Journal Name: | Journal of Hospital Infection |
| Publisher: | Elsevier |
| ISSN: | 0195-6701 |
| ISSN (Online): | 1532-2939 |
| Published Online: | 03 May 2019 |
| Copyright Holders: | Copyright © 2019 The AuthorsThe Healthcare Infection Society |
| First Published: | First published in Journal of Hospital Infection 103(1): e9-e15 |
| Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
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