ment-related SSIs," again finding that laminar airflow probably
increased the rate of infection. The International Society for
Infectious Diseases's Guide to Infection Control in the Hospital
agrees, saying while studies are imperfect, few show a significant
decrease in SSI rates due to laminar airflow.
But there may be good news. Several new products are aimed at
correcting the problems of laminar airflow, and some research indi-
cates that they may work better (see "Could These Devices Help
Prevent SSIs?" on page 54).
Blown away
Two products use horizontal laminar airflow directly over the surgical
site. One product attaches to the patient near the surgical site and
blows sterile air horizontally over the site, creating a sterile "cocoon"
of space and reducing the particle count by more than 84%, the maker
says. Another device attaches to the Mayo stand and is designed to
blow sterile air horizontally over the instruments and implants as well
as over the surgical site. The maker says it reduces particles to fewer
than five per cubic meter.
Studies indicate that the devices, in use in Europe for more than a
decade, appear to work. One study of one of the devices, the Operio
by Toul Meditech, indicated that a mobile horizontal airflow unit, used
in conjunction with a conventional turbulent airflow system, reduced
the particle count by over 85%. Another found that it cut the particle
count by two thirds. A third found that the practice reduced particles
by greater than 60%.
The other product, made by NimbicSystems, was studied by a team
led by Rabih Darouiche, MD, an infectious disease specialist affiliated
with Michael E. DeBakey Veterans Affairs Medical Center in Houston.
Dr. Darouiche was evaluating the link between airborne colony-form-
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