Simple pre-surgical protocol can help prevent dangerous post-surgical infections

A brand new research revealed right now within the American Journal of An infection Management (AJIC) demonstrates using a easy pre-surgical an infection prevention protocol to stop harmful post-surgical infections. Researchers carried out this investigation on the Soroka College Medical Middle in Israel.

Surgical web site infections (SSIs) are a kind of healthcare-associated an infection with lethal penalties for some sufferers. In line with the newest information from the Facilities for Illness Management and Prevention, there have been greater than 110,000 SSIs linked to inpatient surgical procedures within the U.S. in 2015. These infections result in a excessive charge of morbidity and mortality, with a affected person’s estimated threat of dying as a lot as 11 instances greater than regular. SSIs even have a really excessive monetary burden, with the common hospital keep prolonged by practically 10 days and an estimated $20,000 in further hospitalization prices per affected person.

There are a selection of really useful protocols to assist forestall SSIs, however lack of affected person compliance, excessive prices, and bacterial resistance can cut back their utility and effectiveness. On this new research, researchers aimed to judge the outcomes of a protocol designed to scale back SSIs by way of a selected give attention to the Staphylococcus aureus pathogen. The strategy concerned a pre-surgical intranasal utility of povidone-iodine and pores and skin antisepsis utilizing chlorhexidine gluconate (CHG).

The research concerned 688 grownup sufferers who had hip or knee arthroplasty or spine surgical procedure at Soroka College Medical Middle between February 2018 and October 2021. Their outcomes had been in comparison with a retrospective affected person cohort from 2016 and 2017 handled earlier than the povidone-iodine element of the protocol was carried out. Affected person outcomes had been tracked for 90 days after surgical procedure.

Deploying this intervention previous to surgical procedure helped to deal with a broad problem in healthcare, that some 30% of the inhabitants is colonized with S. aureus with out exhibiting signs. The pre-surgical protocol efficiently eradicated S. aureus in practically 40% of sufferers discovered to already harbor the pathogen. That is significantly necessary for affected person outcomes, because the researchers discovered that the presence of S. aureus inside the day following surgical procedure was related to a three-fold threat of creating an SSI. General, the research confirmed a major lower in extreme SSIs amongst sufferers who acquired the newer protocol.

“Our research clearly reveals that we are able to forestall surgical web site infections and preserve sufferers safer by way of using a easy pre-surgical nasal utility of povidone-iodine together with customary CHG bathing,” mentioned Lisa Saidel-Odes, MD, Infectious Ailments specialist at Soroka College Medical Middle and lead creator of the paper. “We famous that the protocol is simplest in circumstances with little S. aureus current and recommend that an extra utility of the povidone-iodine could be wanted for sufferers with larger nasal colonization.”

Extra particulars from the research embrace:

• Of the 688 sufferers included, 28 developed an SSI within the 90-day research window. Sufferers with diabetes had been at significantly elevated threat for creating an SSI.
• Sufferers had been screened for S. aureus previous to surgical procedure. Greater than 16% had been already colonized with both methicillin-sensitive or methicillin-resistant S. aureus.
• Of sufferers who developed SSIs, S. aureus was not the one reason behind an infection. Eleven sufferers had been contaminated with Enterobacterales.

This research reveals the ability of making use of broadly out there antiseptics to scale back SSIs and enhance affected person security. The outcomes are encouraging not solely as a result of the routine is efficient in lowering SSI, but in addition as a result of it’s easy to implement and avoids the chance of antibiotic resistance.”

Tania Bubb, PhD, RN, CIC, FAPIC, 2024 APIC president