Study: Better OR ventilation linked to lower SSI rates

Editor's Note

This Swiss study finds that better OR ventilation properties, as assessed with a new ventilation index, are associated with lower rates of surgical site infections (SSIs) in orthopedic, spine, and cardiac procedures.

Researchers calculated a ventilation index with higher values reflecting less turbulent air displacement instead of comparing laminar air flow with conventional ventilation, which has been done in previous studies. The analysis included 47 hospitals with 182 ORs. Of 163,740 procedures, there were 6791 SSIs.

In hospital-level analyses, a 5-unit increase in the ventilation index was not associated with an overall decrease in the Centers for Disease Control and Prevention's National Healthcare Safety Network-adjusted SSI rates. However, in procedure-stratified analyses, there were significant decreases in SSI rates for knee and hip arthroplasties (-0.41 SSIs per 100 procedures) and lower SSI rates in cardiac procedures (-0.89 SSIs per 100 procedures) and spine procedures (-1.15 SSIs per 100 procedures).

In patient-level, subgroup analysis, a 5-unit increase in the ventilation index was associated with lower rates of superficial infections for knee and hip, cardiac, and spine procedures, and deep incisional infections for knee and hip procedures, but there were no significant associations with organ/space infections.

The researchers concluded that better ventilation properties are associated with lower rates of SSIs, particularly for orthopedic, cardiac, and spine procedures. OR ventilation quality was less relevant for other types of procedures.