Laminar airflow and mixing ventilation: Which is better for operating room airflow distribution near an orthopedic surgical patient?

Background: There has been little research on the performance of laminar airflow (LAF) and mixing ventilation (MV) systems regarding clean airflow distribution near a surgical patient in operating rooms (ORs). The objective of this study was to examine the performance of LAF and MV systems in ORs at St Olays Hospital in Norway. Methods: Experimental measurements were conducted in 2 ORs equipped with LAF and MV systems. Results: Under real operating conditions, airflow distribution from the LAF system was disrupted, and airflow velocity became significantly lower than that of MV above the lying patient. Airflow pattern was observed as distributed vertically downward and horizontally with LAF and MV, respectively. Turbulence intensity of supply airflow from LAF was much lower than that of MV. Conclusions: The airflow distribution by LAF system in close proximity to a patient is greatly affected by thermal plumes generated above incisions by both patients and surgical facilities. The effect of surgical facilities on airflow distribution by using MV is not significant compared to LAF ventilation. New guidelines are needed for the design of clean airflow distribution systems in the vicinity of surgical patients in ORs. (C) 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.