Carmel, NY (PRWEB) December 07, 2011
More than 800,000 joint replacement procedures are done in the United States every year, according to the American Academy of Orthopaedic Surgeons. Total joint replacements, which are done most frequently to relieve the pain and disability caused by severe arthritis, are performed most often on knee and hip joints but also on joints in the ankle, shoulder, fingers, and elbow. ?The risk of postoperative infection is present in all surgical procedures but it can be particularly serious in joint replacement,? says Dr. Joel Buchalter of Somers Orthopaedic Surgery & Sports Medicine. ?While the infection rate for joint replacement has been reduced to 1-2%, our goal is zero infections. And because airborne contaminants in the operating room are the primary cause of infection, creating an ?ultra clean air? environment is an important weapon in our fight against infection.?
Postoperative infection is particularly troublesome in joint replacement because the implant procedure introduces foreign material into the patient’s body. Bacteria are usually well controlled by the body’s own immune system; when an infection is detected, the immune system responds quickly and attacks the infecting bacteria. But an implanted prosthetic joint cannot defend itself against infection the way other tissues can. When bacteria gain access to the area around the prosthesis, it is harder for the immune system to clear the infection with a foreign body amidst the tissues. If an infected implant persists, the problem can worsen and sometimes the implant may need to be removed in order to cure the infection.
Preventing infection requires careful attention prior to surgery, during surgery and after surgery. Prior to surgery, patients and their doctors must ensure that conditions that might introduce bacteria into the body ? such as skin conditions, problems of the teeth and gums, and urinary tract infections ? are treated. These bacteria can be carried by the blood from distant sources in the body to the prosthesis. Similarly, after surgery patients must be attentive to treating cuts promptly and consider taking prophylactic antibiotics before invasive dental work or other procedures.
?But blood-borne bacteria do not pose the greatest risk in joint replacement procedures,? Dr. Buchalter says. ?The majority of infections are caused by airborne particles that are either present in the operating room ? from skin cells shed by the operating room staff and the patient. ? or are introduced through the ventilation system or through infiltration (e.g via a door being opened and closed). That’s why the most advanced facilities use specialized ?clean air? distribution systems that remove these contaminants to reduce the risk of infection.?
Air distribution in a hospital operating room is more complex than in a typical office building, where the primary objective is to quickly mix the air introduced into the room with the air already in the room in order to maintain a comfortable temperature without a draft. In the operating room, this typical system would spread an unacceptable level of airborne contaminants. Clean air environments were developed initially for semiconductor manufacturing and subsequently adapted to operating rooms. They utilize a specialized air distribution system comprised of several components that remove particulate matter from different sources:
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