A COMPARISON OF DEEP INFECTION RATES IN THA AND TKA BEFORE AND AFTER THE INTRODUCTION OF A LAMINAR FLOW OPERATING ROOM

Abstract

The purpose of this study was to determine whether a laminar flow operating system reduces deep infection rates in Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) and to examine the costs involved in implementing laminar flow technology. A retrospective analysis of deep infection rates in 759 patients who underwent THA and TKA was performed in one hospital prior to and after the introduction of a vertical laminar flow operating system together with the use of isolation body exhaust suits. A cost analysis was also performed on the cost of implementing laminar flow technology and the average inpatient hospital cost of managing a deep infection. A control group consisted of 387 THA and TKA performed in 2 years in a conventional operating theatre and follow up carried out to a mean of 29 months. There were 12 recorded deep infections, 3.1%. Case group consisted of 372 THA and TKA performed in 2 years after the introduction of a vertical laminar flow operating theatre together with the use of isolation body exhaust suits, with a mean follow up to 22 months. There were 4 recorded deep infections, 1.1%.

A comparison of deep infection rates yielded p value 0.06. There was a strong trend toward a reduction in deep infection rate in THA and TKA performed in the laminar flow theatre with the use of isolation body exhaust suits. The economic impact of deep infection in THA and TKA is vast and the cost of implementing laminar flow technology must be weighed against the deep infection rate as well as the number of operations performed at an institution.