New study suggests that Laminar Airflow may not play a role in prevention of PJI
A newly published study suggests that laminar airflow may not play a role in prevention of periprosthetic joint infection. In the study almost 7000 patients underwent total joint arthroplasty in operating rooms equipped with either LAF or turbulent airflow. With an appropriate perioperative protocol for infection prevention, LAF does not seem to play a protective role in periprosthetic joint infection prevention. Several studies using data from national joint registries have concluded that the use of LAF could even increase the infection rate after total joint arthroplasty. The parallel airflow of the LAF system can be easily disrupted by objects or personnel around the surgical field, traffic in the room and door openings. WHO does not recommend the use of LAF to reduce the risk of Surgical Site Infections during total joint arthroplasty.
The limitations of existing technologies – both LAF and mixed ventilation – are precisely why we developed Opragon, which combines the classic mixed/diluting ventilation (which dilutes the number of bacteria-carrying particles) with an improved kind of unidirectional airflow.Â
Combining the two techniques in the same operating room produces extremely effective ventilation. Compared to traditional European LAF, Opragon often creates a 3-5x larger critical zone using half the energy. Modern mixed ventilations systems may create that same size of critical zone, but they rely on very tight clothing concepts and use as much energy as LAF. And with corona virus in the air, who wants to work in a room where the air is designed to mix as much as possible?
Furthermore, the downflow with Opragon is very robust since it uses gravity, a fundamental force of nature, to break the convection currents from warm staff and equipment. This effect is created by using air that is colder than room temperature, which also means that it is denser than the surrounding warmer air and drops towards the floor. The system enables reliable and stable control of air movement, and thereby also the airflow’s fall speed over the patient and the sterile-clad staff. The technology reduces the presence of bacteria-carrying particles in the operative zone while at the same time helping to create a comfortable working environment.Â
Two combined system – with gravity as the engine
Why is it so important to reduce the infections? First of all, it is very painful for the patient to get an infection, and it leads to greater suffering and longer hospital stay than necessary. In addition, it costs society huge sums that could be used better. The patient receives a higher dose of antibiotics than is normally required during surgery, which in turn leads to increased antibiotic resistance. Today, 5 times more people die from a post-operative infection than from traffic! We want to change that! Through ultra-clean air throughout the operating room, the proportion of post-operative infections can be significantly reduced.
It is possible to get ultra-clean air in the whole operating room, a comfortable working environment and reduce surgical site infections – with an energy effective ventilation!
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Read the full article here:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771850