Ultraclean air for prevention of postoperative infection after posterior spinal fusion with instrumentation: a comparison between surgeries performed with and without a vertical exponential filtered air-flow system.
METHODS
This study retrospectively compared infection rates between adult patients after posterior spinal instrumentation procedures performed in a conventional versus an ultraclean air operating room.


OBJECTIVE
To evaluate if the use of ultraclean air technology could decrease the infection rate after posterior spinal arthrodesis with instrumentation.


BACKGROUND
Postoperative wound infection after posterior arthrodesis remains a feared complication in spinal surgery. Although this frequent complication results in a significant problem, the employment of ultraclean air technology, as it is commonly used for arthroplasty, has not been reported as a possible alternative to reduce the infection rate after complex spine surgery.


METHODS
One hundred seventy-nine patients having posterior spinal fusion with instrumentation were divided into 2 groups: group I included 139 patients operated in a conventional operating room, and group II included 40 patients operated in a vertical laminar flow operating room. Patient selection was performed favoring ultraclean air technology for elective cases in which high infection risk was considered. A statistical analysis of the infection rate and its associated risk factors between both groups was assessed.


RESULTS
We observed 18 wound infections in group I and 0 in group II. Comparison of infection rates using the chi-squared test showed a statistically significant difference (P <0.017).


CONCLUSIONS
The use of ultraclean air technology reduced the infection rate after complex spinal procedures and appears to be an interesting alternative that still needs to be prospectively studied with a randomized protocol.
Institute of Orthopaedics Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina. mgruenberg@arnet.com.ar
Marcelo F
MF
Gruenberg
Gustavo L
GL
Campaner
Carlos A
CA
Sola
Eligio G
EG
Ortolan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D000391:Air Microbiology; D016902:Air Pollution, Indoor / Q000517:prevention & control; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control; D004780:Environment, Controlled; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000592:standards; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*