The possible effect of different types of ventilation on reducing operation theatre infections: a meta-analysis

Abstract

It has been brought to our attention that this article is very similar to a publication in the journal, Infection Control & Hospital Epidemiology. Due to the timing of publication and difference in authorship between papers, we have decided to not retract this publication in this case, but would like to highlight the nature of this duplicate publication. Introduction The relation between type of ventilation used in the operating theatre and surgical site infection has drawn considerable attention. It has been reported that there is a possible relationship between the type of ventilation used in the operation theatre and surgical site infection. This meta-analysis was performed to evaluate this relationship. Methods Through a systematic literature search up to May 2020, 14 studies describing 590,121 operations, 328,183 were performed under laminar airflow ventilation and 2,611,938 were performed under conventional ventilation. Studies were identified that reported relationships between type of ventilation with its different categories and surgical site infection (10 studies were related to surgical site infection in total hip replacement, 7 in total knee arthroplasties and 3 in different abdominal and open vascular surgery). Odds ratios with 95% confidence intervals were calculated comparing surgical site infection prevalence and type of theatre ventilation using the dichotomous method with a random or fixed-effect model. Findings No significant difference was found between surgery performed under laminar airflow ventilation and conventional ventilation in total hip replacement (OR 1.23; 95% CI 0.97–1.56, p = 0.09), total knee arthroplasties (OR 1.14; 95% CI 0.62–2.09, p = 0.67) or different abdominal and open vascular surgery (OR 0.75; 95% CI 0.43–1.33, p = 0.33). The impact of the type of theatre ventilation may have no influence on surgical site infection as a tool for decreasing its occurrence. Conclusions Based on this meta-analysis, operating under laminar airflow or conventional ventilation may have no independent relationship with the risk of surgical site infection. This relationship forces us not to recommend the use of laminar airflow ventilation since it has a much higher cost compared with conventional ventilation.

Clinical Issues — July 2023

“…2 More recent moderate-quality evidence on the most effective HVAC system parameters also conflicts. 5,[7][8][9][10][11][12] Researchers who used retrospective comparisons did not find a correlation between unidirectional downward airflow and air quality, 5,[7][8][9][10][11] but they did find reduced contamination using other interventions that are known to affect air quality (eg, surgical attire, 12 volume of personnel, 9,10,12 door openings 9,10,12 ).…”