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The effect of type of ventilation used in the operating room and surgical site infection: A meta-analysis

Published online by Cambridge University Press:  01 December 2020

Jian Bao  and
Jianhua Li Open the ORCID record for Jianhua Li [Opens in a new window]
Jian Bao
Affiliation:
Operating room, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang City, Jiangsu, 222000, China
Jianhua Li*
Affiliation:
Operating room, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang City, Jiangsu, 222000, China
*
Author for correspondence: Jianhua Li, E-mail: [email protected]
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Abstracts

Background:

The relation between type of ventilation used in the operating room and surgical site infection has drawn considerable attention with its conflicting results. A possible relationship between the type of ventilation used in the operating room and surgical site infection has been reported. This meta-analysis was performed to evaluate this relationship.

Methods:

A systematic literature search up to May 2020 identified 14 studies with 590,121 operations, 328,183 operations of which were performed under laminar airflow ventilation and 261,938 of which were performed operations under conventional ventilation. These articles reported relationships between type of operating-room ventilation with its different categories and surgical site infection: 10 studies were related to surgical site infection in the total hip replacement; 7 studies in total knee arthroplasties; and 3 studies in different abdominal and open vascular surgery. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated comparing surgical site infection prevalence and type of operating room ventilation using the dichotomous method with a random-effects or fixed-effects model.

Results:

No significant difference was found between operation performed under laminar airflow ventilation and conventional ventilation in total hip replacement (OR, 1.23; 95% CI, 0.97–1.56, P = .09), in total knee arthroplasties (OR, 1.14; 95% CI, 0.62–2.09; P = .67), and in different abdominal and open vascular surgery (OR, 0.75; 95% CI, 0.43-1.33; P = .33). The impact of the type of operating room 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 because it has a much higher cost compared to conventional ventilation.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 8 , August 2021 , pp. 931 - 936
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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