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Meta-Analysis
. 2021 Mar;103(3):145-150.
doi: 10.1308/rcsann.2020.7021.

The possible effect of different types of ventilation on reducing operation theatre infections: a meta-analysis

Q Lv  1 , Y Lu  2 , H Wang  3 , X Li  4 , W Zhang  4 , Mea Abdelrahim  5 , L Wang  6
Affiliations
Meta-Analysis

The possible effect of different types of ventilation on reducing operation theatre infections: a meta-analysis

Q Lv et al. Ann R Coll Surg Engl. 2021 Mar.

Abstract

Introduction: The relation between type of ventilation used in the operating theatre and surgical site infection has drawn considerable attention. It has been reported that there is a possible relationship between the type of ventilation used in the operation theatre and surgical site infection. This meta-analysis was performed to evaluate this relationship.

Methods: Through a systematic literature search up to May 2020, 14 studies describing 590,121 operations, 328,183 were performed under laminar airflow ventilation and 2,611,938 were performed under conventional ventilation. Studies were identified that reported relationships between type of ventilation with its different categories and surgical site infection (10 studies were related to surgical site infection in total hip replacement, 7 in total knee arthroplasties and 3 in different abdominal and open vascular surgery). Odds ratios with 95% confidence intervals were calculated comparing surgical site infection prevalence and type of theatre ventilation using the dichotomous method with a random or fixed-effect model.

Findings: No significant difference was found between surgery performed under laminar airflow ventilation and conventional ventilation in total hip replacement (OR 1.23; 95% CI 0.97-1.56, p = 0.09), total knee arthroplasties (OR 1.14; 95% CI 0.62-2.09, p = 0.67) or different abdominal and open vascular surgery (OR 0.75; 95% CI 0.43-1.33, p = 0.33). The impact of the type of theatre ventilation may have no influence on surgical site infection as a tool for decreasing its occurrence.

Conclusions: Based on this meta-analysis, operating under laminar airflow or conventional ventilation may have no independent relationship with the risk of surgical site infection. This relationship forces us not to recommend the use of laminar airflow ventilation since it has a much higher cost compared with conventional ventilation.

Keywords: Laminar airflow; Operating theatre; Surgical wound infection; Ventilation.

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Figures

Figure 1
Figure 1
Schematic diagram of the study procedure
Figure 2
Figure 2
Frost plot of total hip replacements related to surgical site infections
Figure 3
Figure 3
Frost plot of total knee arthroplasties related to surgical site infections
Figure 4
Figure 4
Frost plot of different abdominal and open vascular surgeries related to surgical site infections
See this image and copyright information in PMC

Comment in

  • Comment on paper by Lv.
    Thomas AM. Thomas AM. Ann R Coll Surg Engl. 2023 Mar;105(3):286-287. doi: 10.1308/rcsann.2021.0307. Epub 2022 Jun 10. Ann R Coll Surg Engl. 2023. PMID: 35686744 Free PMC article. No abstract available.

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