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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 90 - 90
1 Dec 2019
Langvatn H Schrama JC Engesæter LB Hallan G Furnes O Lingaas E Walenkamp G Dale H
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Aim

The aim of this study was to assess the influence of the true operating room (OR) ventilation on the risk of revision due to infection after primary total hip arthroplasty (THA) reported to the Norwegian Arthroplasty Register (NAR).

Method

40 orthopedic units were included during the period 2005 – 2015. The Unidirectional airflow (UDAF) systems were subdivided into small-area, low-volume, vertical UDAF (lvUDAF) (volume flow rate (VFR) (m3/hour) <=10,000 and diffuser array size (DAS) (m2) <=10); large-area, high-volume, vertical UDAF (hvUDAF) (VFR >=10,000 and DAS >=10) and Horizontal UDAF (H-UDAF). The systems were compared to conventional, turbulent ventilation (CV) systems. The association between revision due to infection and OR ventilation was assessed using Cox regression models, with adjustments for sex, age, indication for surgery, ASA-classification, method of fixation, modularity of the components, duration of surgery, in addition to year of primary THA. All included THAs received systemic, antibiotic prophylaxis.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_23 | Pages 55 - 55
1 Dec 2016
Walenkamp G Moojen DJ Hendriks H Goedendorp T Rademacher W Rozema F
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Aim

A previous Dutch guideline for prophylaxis of hematogenous PJI (HPJI) caused defensive medicine and incorrect own guidelines. There was a need for a better national guideline, developed cooperatively by orthopedic surgeons and dentist.

Method

A committee of Dutch Orthopedic and Dental Society, performed a systematic literature review to answer the question: “Is there a difference in the risk for hematogenous infection between always or never giving antibiotic prophylaxis to patients with a joint prosthesis undergoing a dental procedure”.

We included 9 papers as follows:

RCT's and systematic reviews: 539 abstracts > 33 full papers > 1 paper included.

observational studies: 289 abstracts > 12 full papers > 5 papers.

reference-to-reference: 3 papers.

The nine papers’ quality was scored according the GRADE method.

In addition we studied in non-included literature on further information about additional questions of pathophysiology, risk factors and risk procedures.