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Ventilation systems in operating rooms - a health technology assessment

Ventilation systems in operating rooms – a health technology assessment

There is no association between laminar air flow (LAF) with turbulent air flow (TAF) and the incidence of deep infection after surgery. LAF attempts to avoid turbulence and instead strives to precisely direct a linear stream of filtered air to the surgical field. TAF is conventional mixing ventilation based on diffuse and turbulent streams of filtered air with the aim of creating mixed ventilation in the whole operating room.

The purpose of this health technology assessment from the Danish National Board of Health is to produce an overview of the effectiveness of the two ventilation principles in preventing infection and the economics of these ventilation systems with the aim of contributing to the basis for making future investment decisions in Denmark’s health care system. The review was limited to orthopaedic surgery procedures that pose a high risk of infection with the insertion of large foreign objects such as hip and knee prostheses.
The literature was identified through a systematic search process, and the quality of evidence was assessed based on internationally recognized standards.

The marginal costs of LAF versus TAF per operating room are estimated to be DKK 1.5 million (€200.000) in capital investment and about DKK 30.000 (€4000) in annual operating costs.

Postoperative infection results from many diverse causes or conditions in and around patients. This report focuses on one risk factor for infection: the purity of the air in the surgical field.