Laminar airflow versus turbulent airflow in simulated total hip arthroplasty: measurements of colony-forming units, particles, and energy consumption.


Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 29 03 2021
revised: 14 06 2021
accepted: 20 06 2021
pubmed: 29 6 2021
medline: 1 9 2021
entrez: 28 6 2021
Statut: ppublish

Résumé

The optimal type of ventilation in operating theatres for joint arthroplasty has been debated for decades. Recently, the World Health Organization changed its recommendations based on articles that have since been criticized. The economic and environmental impact of ventilation is also currently an important research topic but has not been well investigated. To compare how large, high-volume, laminar airflow (LAF) and turbulent airflow (TAF) ventilation systems perform during standardized simulated total hip arthroplasty (THA), as they pertain to colony-forming units (cfu), particle counts, and energy consumption. Two identical operating theatres were used to perform simulated THA. The only difference was that one was equipped with LAF and the other with TAF. Cfu and particles were collected from key points in the operating theatre, and energy was measured for each simulation. Thirty-two simulations were done in total. LAF had significantly reduced cfu and particle count when compared with TAF, at both 100% and 50% air influx. Furthermore, it was shown that lowering the air influx by 50% in LAF did not significantly affect cfu or particles, although reducing the fresh air influx from 100% to 50% significantly lowered the energy consumption. Most simulations in TAF did not meet the cleanroom requirements. Cfu were significantly lower in LAF at both 100% and 50% air influx. It is possible to reduce fresh air influx in LAF operating theatres by 50%, significantly reducing energy consumption, while still maintaining cfu and particle counts below the ISO classification threshold required for THA surgery.

Sections du résumé

BACKGROUND BACKGROUND
The optimal type of ventilation in operating theatres for joint arthroplasty has been debated for decades. Recently, the World Health Organization changed its recommendations based on articles that have since been criticized. The economic and environmental impact of ventilation is also currently an important research topic but has not been well investigated.
AIM OBJECTIVE
To compare how large, high-volume, laminar airflow (LAF) and turbulent airflow (TAF) ventilation systems perform during standardized simulated total hip arthroplasty (THA), as they pertain to colony-forming units (cfu), particle counts, and energy consumption.
METHODS METHODS
Two identical operating theatres were used to perform simulated THA. The only difference was that one was equipped with LAF and the other with TAF. Cfu and particles were collected from key points in the operating theatre, and energy was measured for each simulation. Thirty-two simulations were done in total.
FINDINGS RESULTS
LAF had significantly reduced cfu and particle count when compared with TAF, at both 100% and 50% air influx. Furthermore, it was shown that lowering the air influx by 50% in LAF did not significantly affect cfu or particles, although reducing the fresh air influx from 100% to 50% significantly lowered the energy consumption. Most simulations in TAF did not meet the cleanroom requirements.
CONCLUSION CONCLUSIONS
Cfu were significantly lower in LAF at both 100% and 50% air influx. It is possible to reduce fresh air influx in LAF operating theatres by 50%, significantly reducing energy consumption, while still maintaining cfu and particle counts below the ISO classification threshold required for THA surgery.

Identifiants

pubmed: 34182062
pii: S0195-6701(21)00242-5
doi: 10.1016/j.jhin.2021.06.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

117-123

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

L V Marsault (LV)

Odense University Hospital, Department of Orthopaedic Surgery and Traumatology, Odense, Denmark.

C Ravn (C)

Odense University Hospital, Department of Orthopaedic Surgery and Traumatology, Odense, Denmark; Kolding Hospital Lillebaelt, Department of Orthopaedic Surgery and Traumatology, Kolding, Denmark.

A Overgaard (A)

Gentofte-Herlev Hospital, Department of Orthopaedic Surgery and Traumatology, Hellerup, Denmark; The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.

L H Frich (LH)

University of Southern Denmark, Department of Clinical Research, Odense, Denmark.

M Olsen (M)

JRV A/S, Greve, Denmark.

T Anstensrud (T)

Niras, Odense, Denmark.

J Nielsen (J)

Fournais Energy ApS, Vedbæk, Denmark.

S Overgaard (S)

Odense University Hospital, Department of Orthopaedic Surgery and Traumatology, Odense, Denmark; University of Southern Denmark, Department of Clinical Research, Odense, Denmark; Copenhagen University Hospital, Bispebjerg, Department of Orthopaedic Surgery and Traumatology, Copenhagen; University of Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Denmark. Electronic address: soeren.overggard@regionh.dk.

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