Nelson J P
Med Instrum. 1976 Nov-Dec;10(6):277-81.
Two horizontal flow, laminar airflow type clean rooms have been used for almost all clean orthopedic surgery at St. Luke's Hospital in Denver since March 1971. This experience covers approximately 4000 cases, including 1100 total hip and total knee arthroplasties. Three different types of helmet aspirator systems have also been evaluated. Our conclusions from this experience are: (1) All types of orthopedic surgery may be easily and conveniently performed in the clean room and with scrubbed personnel wearing helmet aspirator systems; (2) mechanical upkeep of the clean room is minimal; (3) airborne bacteria counts have been reduced at least 80 percent compared to a regular operating room, and more than 90 percent when scrubbed personnel wear the helmet aspirator system; (4) sterile surface contamination, including the wound, has been reduced at least 80 percent; and (5) the deep infection rate for total hip replacements with at least a 2-year follow-up has been 7.6 percent (10/131) in a regular operating room and 1.6 percent (5/319) in the clean room. With the combined use of the clean room, helmet aspirator systems, and perioperative antibiotics, no infections have occurred in an additional 350 cases with a 1-year follow-up.
自1971年3月以来，丹佛圣卢克医院几乎所有的骨科清洁手术都在两个水平流、层流气流型洁净室内进行。这一经验涵盖了约4000例手术，包括1100例全髋关节和全膝关节置换术。还对三种不同类型的头盔式抽吸系统进行了评估。我们从这一经验中得出的结论是：（1）所有类型的骨科手术都可以在洁净室内轻松方便地进行，并且手术人员穿着头盔式抽吸系统进行刷洗；（2）洁净室的机械维护工作量极小；（3）与普通手术室相比，空气传播细菌数量至少减少了80%，当手术人员穿着头盔式抽吸系统时，减少了90%以上；（4）包括伤口在内的无菌表面污染至少减少了80%；（5）在普通手术室中，至少随访2年的全髋关节置换术深部感染率为7.6%（10/131），在洁净室中为1.6%（5/319）。在联合使用洁净室、头盔式抽吸系统和围手术期抗生素的情况下，另外350例随访1年的病例未发生感染。
