Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2017 , Vol 8, Issue 4
Deep Periprosthetic Infection Rates In Total Hip Arthroplasty and Total Knee Arthroplasty Performed With Laminar Air Flow and Space Suits: Short-Term Results
Vahit Emre Özden, Göksel Dikmen, İsmail Remzi Tözün
Acıbadem Üniversitesi, Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul, Türkiye Purpose: To investigate the effects of use of laminar airflow and clean-room dress on early and late infections following surgeon total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Patients and Methods: Three hundred and sixty seven patients who had undergone 428 primary THA (29 simultaneous bilateral, 32 staged bilateral) and 127 patients who had undergone 211 TKA (29 simultaneous bilateral, 32 staged bilateral) between February 2009 and January 2014 were retrospectively analyzed. Standard operation room with LAF was used in all TKA and THA cases, and clean-room dress in 100% of TKA cases and 99.06% of THA cases. All operations were performed by senior surgeon. The infected and non-infected patients were statistically compared for infection rates including the following criteria; a body mass index (BMI) of 40 and over, active smoking, preoperative positivity in urine culture and in nasal swab culture.

Results: Mean follow-up period of the patients following the initial surgery was 36 (range: 6 to 59) months. Late infection rate following THA was 0.46% (n=2) and early infection rate 0.23% (n=1). Early infection rate following TKA was 0.47% (n=1). No significant differences was found in the rates of infection according to positive colonization in the preoperative nasal swab (p=0.27), asymptomatic bacteriuria and positivity in urine culture (p=1.0), a BMI of ≥40 (p=1.0), active smoking (p=0.28) and groups that had different bearing couples (p>0,12). Infection rates were also not different according to simultaneous or staged arthroplasty performance (p>0,05).

Conclusion: Deep infection rates of total joint arthroplasties, which were performed in our clinic with the simultaneous use of LAF and clean-room dress were consistant with the literature and we had lower early infection rates as described in some series. Multi-centered and prospective randomized controlled long follow-up studies are needed to demonstrate the effect of LAF and clean-room dress on prevention of early and late periprosthetic infections. Keywords : periprosthetic infection, laminar airflow, clean-room dress, surgical site infection