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Surgical site infections are associated with increased morbidity and mortality. The role of the operating theatre ventilation system in preventing surgical site infections has been discussed for decades.
We conducted a health technology assessment to evaluate the efficacy of laminar airflow (LAF) in reducing surgical site infections. We included 22 observational studies. All studies were at moderate or serious risk of bias. The effect estimates were imprecise, and there were somewhat lack of consistency of the results across the included studies. For the comparison of LAF with non-LAF, we found that:
- There were no difference in rates of serious surgical site infections (SSI) in all types of surgery and in joint prosthesis surgery (GRADE: low certainty)
- There were no difference in rates of all SSIs in all types of surgery and in joint prosthesis surgery (GRADE: very low certainty)
- We found no studies that provide sufficient information on the effect on mortality
We estimated the additional annual costs for one operating theatre with LAF to be NOK 41 000 discounted over a 30-day period and 77 000 discounted over a 10-year period. The estimate is associated with uncertainty.