From basic research to clinical practice: The impact of laminar airflow filters on surgical site infection in vascular surgery

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Infection Disease & Health Pub Date : 2024-05-11 DOI:10.1016/j.idh.2024.04.004

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Abstract

Background

Laminar airflow filters have been suggested as a potential preventive factor for surgical site infections, given their ability to reduce the airborne microbiological load. However, their role is still unclear, and evidence regarding vascular surgery patients is scarce. Our aim was to assess the impact of laminar-airflow filters on surgical site infections.

Methods

This single-centre retrospective cohort study was conducted with vascular surgery patients who underwent arterial vascular intervention through a groin incision between July 2018 and July 2019 (turbulent airflow cohort) and July 2020 and July 2021 (laminar airflow cohort). Data were prospectively collected from electronic medical files. We estimated the cumulative incidence of surgical site infections and its 95% confident interval (95%CI). A propensity score matching analysis was performed.

Results

We included 200 patients, 78 in the turbulent airflow cohort and 122 in the laminar airflow cohort. The cumulative incidence was 15.4% (12/78; 95%CI: 9.0–25.0%) in the turbulent-airflow cohort and 14.8% (18/122; 95%CI: 9.5 –22.1%) in the laminar-airflow cohort (p-value: 1.00). The propensity score matching yielded a cumulative incidence of surgical site infection of 13.9% (10/72) with turbulent airflow and 12.5% (9/72) with laminar airflow (p-value: 1.00). Risk factors associated with infection were chronic kidney disease (OR 2.70; 95%CI: 1.14–6.21) and a greater body mass index (OR 1.47; 95%CI: 1.01–2.14).

Conclusion

Laminar airflow filters were associated with a non-significant reduction of surgical site infections. Further research is needed to determine its usefulness and cost-effectiveness. Surgical site infection incidence was associated with chronic kidney disease and a greater body mass index. Hence, efforts should be made to optimize the body mass index before surgery and prevent chronic kidney disease in patients with known arterial disease.

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从基础研究到临床实践：层流气流过滤器对血管外科手术部位感染的影响。

背景：层流气流过滤器能够减少空气中的微生物负荷，因此被认为是手术部位感染的潜在预防因素。然而，层流空气过滤器的作用尚不明确，有关血管手术患者的证据也很少。我们的目的是评估层流空气过滤器对手术部位感染的影响：这项单中心回顾性队列研究的对象是在 2018 年 7 月至 2019 年 7 月（湍流气流队列）和 2020 年 7 月至 2021 年 7 月（层流气流队列）期间通过腹股沟切口接受动脉血管介入治疗的血管外科患者。我们从电子病历中收集了前瞻性数据。我们估算了手术部位感染的累积发生率及其 95% 置信区间 (95%CI)。我们还进行了倾向得分匹配分析：我们共纳入了 200 例患者，其中 78 例属于湍流气流队列，122 例属于层流气流队列。湍流气流队列的累计发病率为 15.4%（12/78；95%CI：9.0-25.0%），层流气流队列的累计发病率为 14.8%（18/122；95%CI：9.5-22.1%）（P 值：1.00）。倾向得分匹配结果显示，湍流气流的手术部位感染累计发生率为 13.9%（10/72），层流气流的手术部位感染累计发生率为 12.5%（9/72）（P 值：1.00）。与感染相关的风险因素有慢性肾病（OR 2.70；95%CI：1.14-6.21）和体重指数较大（OR 1.47；95%CI：1.01-2.14）：结论：层流气流过滤器可显著减少手术部位感染。结论：层流空气过滤器与手术部位感染的减少无明显关系，需要进一步研究确定其实用性和成本效益。手术部位感染的发生与慢性肾病和体重指数较大有关。因此，在手术前应努力优化体重指数，并预防已知动脉疾病患者的慢性肾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection Disease & Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

5.70

自引率

5.70%

发文量

审稿时长

20 days

期刊介绍： The journal aims to be a platform for the publication and dissemination of knowledge in the area of infection and disease causing infection in humans. The journal is quarterly and publishes research, reviews, concise communications, commentary and other articles concerned with infection and disease affecting the health of an individual, organisation or population. The original and important articles in the journal investigate, report or discuss infection prevention and control; clinical, social, epidemiological or public health aspects of infectious disease; policy and planning for the control of infections; zoonoses; and vaccination related to disease in human health. Infection, Disease & Health provides a platform for the publication and dissemination of original knowledge at the nexus of the areas infection, Disease and health in a One Health context. One Health recognizes that the health of people is connected to the health of animals and the environment. One Health encourages and advances the collaborative efforts of multiple disciplines-working locally, nationally, and globally-to achieve the best health for people, animals, and our environment. This approach is fundamental because 6 out of every 10 infectious diseases in humans are zoonotic, or spread from animals. We would be expected to report or discuss infection prevention and control; clinical, social, epidemiological or public health aspects of infectious disease; policy and planning for the control of infections; zoonosis; and vaccination related to disease in human health. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in this ever-changing field. The audience of the journal includes researchers, clinicians, health workers and public policy professionals concerned with infection, disease and health.