Impianto di ventilazione e condizionamento a contaminazione controllata (VCCC), contaminazione microbica dell’aria e infezione del sito chirurgico in interventi di artroprotesi:il progetto ISCHIA del GISIO- SItI

Aim of the ISChIA Project was to evaluate the association between heating, ventilation and air conditioning
(HVAC) systems, microbial air contamination, and surgical site infections in hip and knee arthroplasty as a
contribution to the debate on the protective role of unidirectional airflow in surgical site infections. A total
of 14 hospitals and 28 operating theatres were included in the study. During each operation, microbial air
contamination was evaluated by means of passive and active samplings. The number of people and the
number of door openings were also recorded. Surgical site infection surveillance was conducted according
to the HELICS protocol.
The preliminary results show that low microbial contamination is associated with a lower risk of surgical
site infection, although no significant protective effect is evident. Despite the economic cost of equipping
an operating theatre with a unidirectional air flow system, air microbial values in such theatres were often
higher than expected, suggesting that such theatres were badly managed.
Further studies on this controversial subject are thus needed as well as training interventions aimed at
improving the behaviour of operators.