AIR CONTAMINATION DURING HIP AND KNEE ARTHROPLASTIES - HORIZONTAL LAMINAR-FLOW RANDOMIZED VS CONVENTIONAL VENTILATION

In a randomized study 90 patients, operated on with a total hip or kne e arthroplasty, were allocated to 1 of 3 different regimes, all includ ing a reinforced single-use operating gown: (1) horizontal laminar flo w ventilation and conventional clothes (cotton shirts and trousers) fo r all staff members, (2) horizontal laminar flow ventilation and occlu sive garments (Klinidress) and (3) conventional ventilation and occlus ive garments. Volumetric air sampling gave a low mean number of colony -forming units (< 10 cfu/m(3)) in the vicinity of the wound in all 3 g roups. Laminar ventilation, with or without occlusive staff garments, resulted in less air contamination compared to conventional ventilatio n. During knee arthroplasty, the use of occlusive clothes in the lamin ar ventilation room, further reduced the number of airborne, bacteria- carrying particles to around 1 cfu/m(3). No such reduction was seen du ring hip arthroplasty. We conclude that hip and knee arthroplasties ca n be performed in operating theaters with conventional ventilation whe n occlusive staff garments are used, However, laminar air flow ventila tion in knee surgery, preferably in combination with occlusive garment s, resulted in a substantially lower air contamination and should be p referred.