Infection control practices to reduce airborne bacteria during total knee replacement: A hospital survey in four states

Infection Control and Hospital Epidemiology

Volumn 26, Issue 12, 2005, Pages 910-915

  Miner, Andrew L ^a,b   Losina, Elena ^a,c   Katz, Jeffrey N ^a   Fossel, Anne H ^a   Platt, Richard ^a,b,d  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

^c BOSTON UNIVERSITY SCHOOL OF PUBLIC HEALTH   (United States)

^d NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AIR MONITORING; AIRBORNE INFECTION; CONFIDENCE INTERVAL; HEALTH CARE FACILITY; INFECTION CONTROL; LAMINAR AIRFLOW; QUESTIONNAIRE; REVIEW; TOTAL KNEE REPLACEMENT; ULTRAVIOLET RADIATION; UNITED STATES;

AIR MICROBIOLOGY; ARTHROPLASTY, REPLACEMENT, KNEE; ENVIRONMENT, CONTROLLED; HEALTH CARE SURVEYS; HOSPITALS; HUMANS; INFECTION CONTROL; PROTECTIVE CLOTHING; ULTRAVIOLET RAYS; UNITED STATES;

EID: 30644465577     PISSN: 0899823X     EISSN: None     Source Type: Journal    
DOI: 10.1086/505452     Document Type: Review

References (44)

1. Chow TT, Yang XY. Ventilation performance in operating theatres against airborne infection: review of research activities and practical guidance. J Hosp Infect 2004;56:85-92.
2. Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D. Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. BMJ 1982;285:10-14.
3. Marotte JH, Lord GA, Blanchard JP, et al. Infection rate in total hip arthroplasty as a function of air cleanliness and antibiotic prophylaxis: 10-year experience with 2,384 cementless Lord madreporic prostheses. J Arthroplasty 1987;2:77-82.
4. Fitzgerald RH Jr. Total hip arthroplasty sepsis: prevention and diagnosis. Orthop Clin North Am 1992;23:259-264.
5. Salvati EA, Robinson RP, Zeno SM, Koslin BL, Brause BD, Wilson PD Jr. Infection rates after 3,175 total hip and total knee replacements performed with and without a horizontal unidirectional filtered airflow system. J Bone Joint Surg Am 1982;64:525-535.
6. Turner RS. Laminar air flow: its original surgical application and long-term results. J Bone Joint Surg Am 1974;56:430-435.
7. Nelson JP. Five years experience with operating room clean rooms and personnel-isolator systems. Medical Instrumentation 1976;10:277-281.
8. Franco JA, Baer H, Enneking WF. Airborne contamination in orthopedic surgery: evaluation of laminar air flow system and aspiration suit. Clin Orthop 1977;(122):231-243.
9. Ahl T, Dalen N, Jorbeck H, Hoborn J. Air contamination during hip and knee arthroplasties: horizontal laminar flow randomized vs. conventional ventilation. Acta Orthop Scand 1995;66:17-20.
10. Bubble MJ, Weale AE, Perez JV, Bowker KE, MacGowan AP, Bannister GC. Clothing in laminar-flow operating theatres. J Hosp Infect 1996;32:1-7.
11. Ritter MA, Eitzen HE, Hart JB, French ML. The surgeon's garb. Clin Orthop 1980;(153):204-209.
12. Blomgren G, Hambraeus A, Malmborg AS. The influence of the total body exhaust suit on air and wound contamination in elective hip-operations. J Hosp Infect 1983;4:257-268.
13. Bohn WW, McKinsey DS, Dykstra M, Koppe S. The effect of a portable HEPA-filtered body exhaust system on airborne microbial contamination in a conventional operating room. Infect Control Hosp Epidemiol 1996;17:419-422.
14. Shaw JA, Bordner MA, Hamory BH. Efficacy of the Steri-Shield filtered exhaust helmet in limiting bacterial counts in the operating room during total joint arthroplasty. J Arthroplasty 1996;11:469-473.
15. Friberg B, Friberg S, Ostensson R, Burman LG. Surgical area contamination-comparable bacterial counts using disposable head and mask and helmet aspirator system, but dramatic increase upon omission of head-gear: an experimental study in horizontal laminar airflow. J Hosp Infect 2001;47:110-115.
16. Der TJ, Ong SM, Taub NA, Taylor GJ. Body-exhaust suit versus occlusive clothing: a randomised, prospective trial using air and wound bacterial counts. J Bone Joint Surg Br 2003;85:490-494.
17. Ad Hoc Committee of the Committee on Trauma. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg 1964;160(suppl 2):1-192.
18. Moggio M, Goldner JL, McCollum DE, Beissinger SF. Wound infections in patients undergoing total hip arthroplasty: ultraviolet light for the control of airborne bacteria. Arch Surg 1979;114:815-823.
19. Goldner JL, Moggio M, Beissinger SF, McCollum DE. Ultraviolet light for the control of airborne bacteria in the operating room. Ann N Y Acad Sci 1980;353:271-284.
20. Lowell JD, Kundsin RB, Schwartz CM, Pozin D. Ultraviolet radiation and reduction of deep wound infection following hip and knee arthroplasty. Ann N Y Acad Sci 1980;353:285-293.
21. Carlsson AS, Nilsson B, Walder MH, Osterberg K. Ultraviolet radiation and air contamination during total hip replacement. J Hosp Infect 1986;7:176-184.
22. Berg M, Bergman BR, Hoborn J. Shortwave ultraviolet radiation in operating rooms. J Bone Joint Surg Br 1989;71:483-485.
23. Sanzen L, Carlsson AS, Walder M. Occlusive clothing and ultraviolet radiation in hip surgery. Acta Orthop Scand 1989;60:664-667.
24. Berg M, Bergman BR, Hoborn J. Ultraviolet radiation compared to an ultra-clean air enclosure: comparison of air bacteria counts in operating rooms. J Bone Joint Surg Br 1991;73:811-815.
25. Taylor GJ, Bannister GC, Leeming JP. Wound disinfection with ultraviolet radiation. J Hosp Infect 1995;30:85-93.
26. Dharan S, Pittet D. Environmental controls in operating theatres. J Hosp Infect 2002;51:79-84.
27. Pittet D, Ducel G. Infectious risk factors related to operating rooms. Infect Control Hosp Epidemiol 1994;15:456-462.
28. Turpin IM. Laminar airflow systems. AORN J 1998;68:366-368.
29. Gosden PE, MacGowan AP, Bannister GC. Importance of air quality and related factors in the prevention of infection in orthopaedic implant surgery. J Hosp Infect 1998;39:173-180.
30. Lew D, Pittet D, Waldvogel F. Infections that complicate the insertion of prosthetic devices. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. Galveston, TX: Williams & Wilkins; 1996:731-748.
31. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20:250-278.
32. National Health Service Estates. Health Technical Memorandum 2025: Ventilation in Healthcare Premises. London: HMSO; 1994.
33. Sehulster L, Chinn RY. Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 2003;52(RR-10):1-42.
34. Humphreys H, Taylor EW. Operating theatre ventilation standards and the risk of postoperative infection. J Hosp Infect 2002;50:85-90.
35. Katz JN, Barrett J, Mahomed NN, Baron JA, Wright J, Losina E. Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. J Bone Joint Surg Am 2004;86-A:1909-1916.
36. American Hospital Association. American Hospital Association Annual Survey of Hospitals, 2000. Chicago: American Hospital Association; 2000.
37. Persson U, Montgomery F, Carlsson A, Lindgren B, Ahnfelt L. How far does prophylaxis against infection in total joint replacement offset its cost? BMJ 1988;296:99-102.
38. Berg-Perier M, Cederblad A, Persson U. Ultraviolet radiation and ultra-clean air enclosures in operating rooms: UV-protection, economy, and comfort. J Arthroplasty 1992;7:457-463.
39. McQuarrie DG, Glover JL, Olson MM. Laminar airflow systems: issues surrounding their effectiveness. AORN J 1990;51:1035-1048.
40. National Institute for Occupational Safety and Health. Criteria for a Recommended Standard for Occupational Exposure to Ultraviolet Radiation. Washington, DC: DHHS (NIOSH); 1972. Publication No. 73-11009.
41. Hanssen AD, Osmon DR, Nelson CL. Prevention of deep periprosthetic joint infection. Instr Course Lect 1997;46:555-567.
42. Belkin NL. Laminar airflow and surgical wound infections. AORN J 1998;68:273-275.
43. Purcell JJ Jr, Krachmer JH. Hazards of ultraviolet light [letter]. N Engl J Med 1976;294:116.
44. Lidwell OM. Ultraviolet radiation and the control of airborne contamination in the operating room. J Hosp Infect 1994;28:245-248.