Influence of the operating theatre ventilation system on prosthetic joint infections: the ISChIA study of the Italian Group of Study GISIO – SItI
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Data di Pubblicazione:
2012
Citazione:
Influence of the operating theatre ventilation system on prosthetic joint infections: the ISChIA study of the Italian Group of Study GISIO – SItI / F. Auxilia, A. Agodi, M. Barchitta, D. D’Alessandro, I. Mura, M. Nobile, C. Pasquarella. ((Intervento presentato al 8. convegno International Healthcare Infection Society Conference tenutosi a Liverpool nel 2012.
Abstract:
Background
The role of unidirectional air flow (UAF) in preventing surgical site
infections (SSI) following interventions of hip replacements has been
challenged by recent studies showing no benefit and even greater risk.
These studies did not evaluate the air microbiological quality of
operating theatres (OT) presuming its coherence with the
characteristic of the Heating, Ventilation and Air Conditioning (HVAC)
system.
Aim(s)/Objective(s)
The multicentre ISChIA (Infezioni del Sito Chirurgico in Interventi
di Artroprotesi) study funded by the Italian Ministry of Health was
aimed at evaluating the association between HVAC used in OTs,
microbial air contamination and risk of SSI in hip and knee prosthesis
in order to give a contribution to the debate about the protecting
role of UAF.
• Method
Microbial air contamination was evaluated in the patient area of OT,
once when empty and during each operation by passive (Index of
Microbial Air contamination, IMA) and active sampling (colony forming
unit, cfu/m3). SSI surveillance was conducted according to the HELICS
protocol (2004).
• Results
1,232 interventions were included, 60.2% of hip and 39.8% of knee
replacements. In 42.9% an UAF was available. Microbial contamination
was shown to increase significantly during the interventions; in more
than half air samplings collected in UAF-OT, microbial contamination
was higher than the recommended levels. IMA values positively
correlated with the number of persons and the number of door openings.
No association was shown between risk of SSI and the characteristic
of the HVAC, even though a lower risk of SSI was observed in
operations performed in OTs with the microbial air quality consistent
with the UAF, although not significantly.
• Discussion, and/or Conclusion
Our study failed in showing any protective role of UAF on SSI. However, despite
the high costs of UAF system the levels of air contamination were
often higher than expected; therefore, an evaluation of the UAF
technology cannot be performed without an appraisal of the level of
air contamination levels.
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Elenco autori:
F. Auxilia, A. Agodi, M. Barchitta, D. D’Alessandro, I. Mura, M. Nobile, C. Pasquarella
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