Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, Germany.
J Hosp Infect. 2012 Jun;81(2):73-8. doi: 10.1016/j.jhin.2012.04.008. Epub 2012 May 9.
Many hospitals use ultraclean ventilation (UVC), also known as laminar airflow systems (LAF), in their operating rooms to decrease rates of surgical site infections (SSIs). However, the evidence for these systems is limited and the additional expenses for LAF are substantial.
To determine the effectiveness of LAF to decrease SSI rates following hip and knee prosthesis.
Systematic review of cohort studies investigating the influence of LAF on SSIs following hip and knee prosthesis published during the last 10 years.
Four cohort studies using the endpoint severe SSI following knee prosthesis and four studies following hip prosthesis were included. No individual study showed a significant benefit for LAF following knee prosthesis but one small study showed a significant benefit following hip prosthesis. However, one individual study showed significantly higher severe SSI rates following knee prosthesis and three studies significantly higher SSI rates following hip prosthesis under LAF conditions. The summary odds ratio was 1.36 (95% confidence interval: 1.06-1.74) for knee prosthesis and 1.71 (1.21-2.41) for hip prosthesis.
It would be a waste of resources to establish new operating rooms with LAF, and questionable as to whether LAF systems in existing operating rooms should be replaced by conventional ventilation systems.
许多医院在手术室使用超净通风（UVC），也称为层流气流系统（LAF），以降低手术部位感染（SSI）的发生率。然而，这些系统的证据有限，并且 LAF 的额外费用很高。
确定 LAF 降低髋关节和膝关节假体手术后 SSI 发生率的效果。
系统评价了过去 10 年发表的关于 LAF 对髋关节和膝关节假体术后 SSI 影响的队列研究。
纳入了四项使用膝关节假体术后严重 SSI 作为终点的队列研究和四项髋关节假体术后的研究。没有一项单独的研究表明 LAF 对膝关节假体有显著益处，但一项小型研究表明 LAF 对髋关节假体有显著益处。然而，一项单独的研究显示，在 LAF 条件下，膝关节假体的严重 SSI 发生率明显更高，三项研究显示髋关节假体的 SSI 发生率明显更高。膝关节假体的汇总优势比为 1.36（95%置信区间：1.06-1.74），髋关节假体为 1.71（1.21-2.41）。
建立带有 LAF 的新手术室将是一种资源浪费，而对于现有手术室中的 LAF 系统是否应被传统通风系统取代存在疑问。
