Ahl T, Dalén N, Jörbeck H, Hoborn J
Karolinska Institute, Department of Orthopedics, Danderyd Hospital, Sweden.
Acta Orthop Scand. 1995 Feb;66(1):17-20. doi: 10.3109/17453679508994632.
In a randomized study 90 patients, operated on with a total hip or knee arthroplasty, were allocated to 1 of 3 different regimes, all including a reinforced single-use operating gown: (1) horizontal laminar flow ventilation and conventional clothes (cotton shirts and trousers) for all staff members, (2) horizontal laminar flow ventilation and occlusive garments (Klinidress) and (3) conventional ventilation and occlusive garments. Volumetric air sampling gave a low mean number of colony-forming units (< 10 cfu/m3) in the vicinity of the wound in all 3 groups. Laminar ventilation, with or without occlusive staff garments, resulted in less air contamination compared to conventional ventilation. During knee arthroplasty, the use of occlusive clothes in the laminar ventilation room, further reduced the number of airborne, bacteria-carrying particles to around 1 cfu/m3. No such reduction was seen during hip arthroplasty. We conclude that hip and knee arthroplasties can be performed in operating theaters with conventional ventilation when occlusive staff garments are used. However, laminar air flow ventilation in knee surgery, preferably in combination with occlusive garments, resulted in a substantially lower air contamination and should be preferred.
在一项随机研究中，90例行全髋关节或膝关节置换术的患者被分配到3种不同方案中的一种，所有方案均包括一件强化一次性手术衣：（1）所有工作人员采用水平层流通风并穿着传统服装（棉质衬衫和裤子）；（2）水平层流通风并穿着封闭性服装（Klinidress）；（3）传统通风并穿着封闭性服装。容积式空气采样显示，所有3组患者伤口附近的平均菌落形成单位数量均较低（<10 cfu/m³）。与传统通风相比，无论有无封闭性工作人员服装，层流通风导致的空气污染都更少。在膝关节置换术中，在层流通风室内使用封闭性服装，可进一步将空气中携带细菌的颗粒数量减少至约1 cfu/m³。在髋关节置换术中未观察到这种减少。我们得出结论，当使用封闭性工作人员服装时，髋关节和膝关节置换术可在采用传统通风的手术室中进行。然而，膝关节手术中采用层流通风，最好与封闭性服装相结合，会使空气污染显著降低，应优先选择。
