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In‐Room Ultraviolet Air Filtration Units Reduce Airborne Particles During Total Joint Arthroplasty
Author(s) -
Anis Hiba K.,
Curtis Gan L.,
Klika Alison K.,
Piuzzi Nicolas S.,
Otiso Joshua,
Richter Sandra S.,
Barsoum Wael K.,
Higuera Carlos A.
Publication year - 2020
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.24453
Subject(s) - bioburden , joint arthroplasty , filtration (mathematics) , air filtration , hepa , colony forming unit , medicine , particle counter , air filter , zoology , surgery , nuclear medicine , chemistry , aerosol , environmental science , environmental engineering , arthroplasty , biology , mathematics , indoor air quality , bacteria , genetics , statistics , organic chemistry , filter (signal processing) , computer science , engineering , inlet , computer vision , mechanical engineering
Reducing airborne bioburden in total joint arthroplasty (TJA) is of critical importance. The efficacy of crystalline ultraviolet‐C (C‐UVC) filtration in reducing bioburden in a dynamic operating room (OR) environment has not been evaluated. We assessed whether C‐UVC filtration reduced (i) total particle counts (TPC); (ii) viable particle counts (VPC); and (iii) colony‐forming units (CFUs). Fifty primary TJA cases were performed in a positive‐pressure OR; 25 cases with the C‐UVC unit and 25 cases without. The air was sampled by a particle counter and an impact air sampler to measure particle counts and CFUs, respectively. To compare TPC, VPC, and CFU/m 3 between groups, independent t tests and multivariate regression, adjusted for number of OR staff and door openings, were performed. The C‐UVC group had significantly lower TPC (2.6 × 10 6 vs. 4.7 × 10 6 particles, p = 0.001) and VPC (18,605 vs. 27,516 particles, p = 0.001). There were fewer CFUs in the C‐UVC group (10.9 CFU/m 3 vs. 13.7 CFU/m 3 , p = 0.163). Multivariate analysis identified C‐UVC filtration as a significant predictor of decreased TPC (β = −0.44, p = 0.002) and VPC (β = −0.47, p = 0.001) after accounting for door openings and number of OR staff. The reduction in CFUs was not significant on multivariate analysis. In this prospective pilot study, a C‐UVC air disinfection and recirculation unit led to a significant reduction in both TPC and VPC and a non‐significant reduction in CFU. Statement of clinical significance: Further studies are needed to investigate the effects of C‐UVC filtration units on surgical‐site infection rates. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:431‐437, 2020