Table 2.
Brief summary of the Included studies
| Study Id and Year | Journal of publication | Type of study | Total number of surgical departments | Total number of orthopedic surgeries | Intervention | Types of surgical facility | Number of departments | Outcomes: bacterial count in site sampled air (CFU/m3), risk of SSI, reduction in SSI | Conclusion | p value | References |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Friberg et al. (2001) | The Journal of hospital infection | Comparative study | 5 | 30 | Surgical area contamination—comparison with or without laminar air-flow | Facility without LAF | 14/30 | Bacterial count in site sampled air 8 CFU/m3 | Use of horizontal LAF units is seriously questionable | < 0.001 | [17] |
| Facility with LAF | 16/30 | Bacterial count in site sampled air 22 CFU/m3 | |||||||||
| Kakwani et al. (2007) | Injury | consecutive cohort-study | 88 | 435 | To study the effect of laminar air-flow on the outcomes of hemiarthroplasty | Facility without LAF | 223/435 | Bacterial count in site sampled air 0.45 CFU/m3 | Laminar air-flow equipped theatres were recommended for hemiarthroplasty procedures | < 0.001 | [18] |
| Facility with LAF | 212/435 | Bacterial count in site sampled air 5.4 CFU/m3 | |||||||||
| Brandt et al. (2008) | Annals of Surgery | Retrospective cohort-study | 44 | 99,230 | Effect of Operating Room Ventilation with Laminar Airflow on the Surgical Site Infection (SSI) Rate | Facility without LAF | 31,573/99230 | Risk of SSI 1.06 | OR ventilation with laminar airflow showed no benefit and associated with a significantly higher risk for severe SSI after surgery | < 0.001 | [19] |
| Facility with LAF | 67,707/99230 | Risk of SSI 1.63 | |||||||||
| Nilson et al. (2010) | The Journal of hospital infection | Comparative study | 22 | 8550 | Assessment of laminar air flow reduced infection during surgery | Facility without LAF | 3256/8550 | Bacterial count in site sampled air 45 CFU/m3 | LAF is efficient for reducing infection in operating room | < 0.001 | [20] |
| Facility with LAF | 4725/8550 | Bacterial count in site sampled air 275 CFU/m3 | |||||||||
| Sossai et al. (2011) | Journal of orthopaedics and traumatology | Comparative study | 2 | 17 | Effect of LAF unit in reducing the bacterial contamination | Facility without LAF | 6/17 | Bacterial count in site sampled air 23.5 CFU/m3 | LAF unit not helps in reducing the bacterial contamination of the wound area | < 0.05 | [21] |
| Facility with LAF | 11/17 | Bacterial count in site sampled air 3.5 CFU/m3 | |||||||||
| Hooper et al. (2011) | The Journal of bone and joint surgery | Retrospective study | 50 | 36,826 | Effect of laminar flow in reducing the infections after total hip and knee replacement surgery | Facility without LAF | 14,730/36826 | Risk of SSI 0.110 | Deep infections were not reduced by using the laminar air flow | < 0.001 | [22] |
| Facility with LAF | 9206/36826 | Risk of SSI 0.082 | |||||||||
| Bosanquet et al. (2013) | Annals of the Royal college of Surgeons of England | Retrospective study | 45 | 170 | Effect of Laminar flow in reducing the surgical site infections in patients after surgery | Facility without LAF | 114/170 | Reduction in Surgical site infections 17% | laminar flow not helps in reducing the incidences of SSIs in patients after surgery | < 0.05 | [23] |
| Facility with LAF | 56/170 | Reduction in Surgical site infections 7% | |||||||||
| Pinder et al. (2016) | The bone and joint journal | Observational study | 19 | 803 065 | an observational study to demonstrate whether laminar flow ventilation reduce the rate of infection | Facility without LAF | 296,653/803065 | Reduction in Surgical site infections 2.7% | Installation of laminar flow causes no change in the incidences of SSIs | < 0.05 | [24] |
| Facility with LAF | 562,412/803065 | Reduction in Surgical site infections 3.8% | |||||||||
| Wang et al. (2020) | Orthopedics | Original cohort investigation | 2 | 6972 | Association of Laminar Airflow with Infection during total arthroplasty | Facility without LAF | 3027/6972 | Reduction in Surgical site infection 0.4% | There is no benefit of LAF in operating rooms | < 0.05 | [25] |
| Facility with LAF | 3945/6972 | Reduction in Surgical site infection 0.5% | |||||||||
| Langvatan et al. (2020) | Journal of hospital infection | Original investigation | 62 | 51,292 | Assessment of operating room ventilation and the risk of infection after total hip arthroplasty | Facility without LAF | 2046/4313 | Risk of SSI 0.7 | Chances of infection is less without LAF than with LAF | 0.01 | [26] |
| Facility with LAF | 2647/4313 | Risk of SSI 0.9 |