Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis
Abstract Background Laminar airflow (LAF) technologies minimize infectious microorganisms to enhance air quality and surgical site infections (SSIs). LAF lowers SSIs in some clinical studies but not others. This study analyzes laminar airflow ventilation's capacity to reduce orthopaedic surgery...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03992-2 |
| _version_ | 1797557684368572416 |
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| author | Xueqian Ouyang Qiaolin Wang Xiaohua Li Ting Zhang Sanjay Rastogi |
| author_facet | Xueqian Ouyang Qiaolin Wang Xiaohua Li Ting Zhang Sanjay Rastogi |
| author_sort | Xueqian Ouyang |
| collection | DOAJ |
| description | Abstract Background Laminar airflow (LAF) technologies minimize infectious microorganisms to enhance air quality and surgical site infections (SSIs). LAF lowers SSIs in some clinical studies but not others. This study analyzes laminar airflow ventilation's capacity to reduce orthopaedic surgery-related SSIs. Methods The PRISMA-compliant keywords were utilized to conduct a search for pertinent articles in various databases including PubMed, MEDLINE, CENTRAL, Web of Sciences, and the Cochrane databases. Observational studies, including retrospective, prospective, and cohort designs, satisfy the PICOS criteria for research methodology. The assessment of quality was conducted utilizing the Robvis software, while the meta-analysis was performed using the RevMan application. The study’s results were assessed based on effect sizes of odds ratio (OR) and risk ratio (RR). Results From 2000 to 2022, 10 randomized controlled clinical trials with 10,06,587 orthopaedic surgery patients met the inclusion criteria. The primary outcomes were: (1) Risk of SSI, (2) Bacterial count in sampled air and (3) Reduction in SSIs. The overall pooled OR of all included studies was 1.70 (95% CI 1.10–2.64), and the overall pooled RR was 1.27 (95% CI 1.02–1.59) with p < 0.05. LAF is ineffective at preventing SSIs in orthopaedic procedures due to its high-risk ratio and odds ratio. Conclusions The present meta-analysis has determined that the implementation of LAF systems does not result in a significant reduction in the incidence of surgical site infections (SSIs), bacterial count in the air, or SSIs occurrence in orthopaedic operating rooms. Consequently, the installation of said equipment in operating rooms has been found to be both expensive and inefficient. |
| first_indexed | 2024-03-10T17:20:08Z |
| format | Article |
| id | doaj.art-3f85a7fcb31f4bf3aa57a940c71242d7 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-10T17:20:08Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-3f85a7fcb31f4bf3aa57a940c71242d72023-11-20T10:20:52ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-08-0118111410.1186/s13018-023-03992-2Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysisXueqian Ouyang0Qiaolin Wang1Xiaohua Li2Ting Zhang3Sanjay Rastogi4Anesthesia operating room, Xianyang Central HospitalDepartment of Internal Medicine Ward I, Yantai Qishan HospitalVasculocardiology Department, Xianyang Central HospitalAnesthesia operating room, Northwest Women’s and Children’s HospitalESIC Model Hospital, ESICAbstract Background Laminar airflow (LAF) technologies minimize infectious microorganisms to enhance air quality and surgical site infections (SSIs). LAF lowers SSIs in some clinical studies but not others. This study analyzes laminar airflow ventilation's capacity to reduce orthopaedic surgery-related SSIs. Methods The PRISMA-compliant keywords were utilized to conduct a search for pertinent articles in various databases including PubMed, MEDLINE, CENTRAL, Web of Sciences, and the Cochrane databases. Observational studies, including retrospective, prospective, and cohort designs, satisfy the PICOS criteria for research methodology. The assessment of quality was conducted utilizing the Robvis software, while the meta-analysis was performed using the RevMan application. The study’s results were assessed based on effect sizes of odds ratio (OR) and risk ratio (RR). Results From 2000 to 2022, 10 randomized controlled clinical trials with 10,06,587 orthopaedic surgery patients met the inclusion criteria. The primary outcomes were: (1) Risk of SSI, (2) Bacterial count in sampled air and (3) Reduction in SSIs. The overall pooled OR of all included studies was 1.70 (95% CI 1.10–2.64), and the overall pooled RR was 1.27 (95% CI 1.02–1.59) with p < 0.05. LAF is ineffective at preventing SSIs in orthopaedic procedures due to its high-risk ratio and odds ratio. Conclusions The present meta-analysis has determined that the implementation of LAF systems does not result in a significant reduction in the incidence of surgical site infections (SSIs), bacterial count in the air, or SSIs occurrence in orthopaedic operating rooms. Consequently, the installation of said equipment in operating rooms has been found to be both expensive and inefficient.https://doi.org/10.1186/s13018-023-03992-2HEPA filtersLaminar air flowMeta-analysisOrthopaedic surgeriesOperating roomsSurgical site infections |
| spellingShingle | Xueqian Ouyang Qiaolin Wang Xiaohua Li Ting Zhang Sanjay Rastogi Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research HEPA filters Laminar air flow Meta-analysis Orthopaedic surgeries Operating rooms Surgical site infections |
| title | Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis |
| title_full | Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis |
| title_fullStr | Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis |
| title_full_unstemmed | Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis |
| title_short | Laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections: a systematic review and meta-analysis |
| title_sort | laminar airflow ventilation systems in orthopaedic operating room do not prevent surgical site infections a systematic review and meta analysis |
| topic | HEPA filters Laminar air flow Meta-analysis Orthopaedic surgeries Operating rooms Surgical site infections |
| url | https://doi.org/10.1186/s13018-023-03992-2 |
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