A new study published in the American Journal of Infection Control demonstrates the use of an undeniable pre-surgical infection prevention protocol to avoid harmful post-surgical infections. Researchers conducted the survey at Soroka University Medical Center in Israel.
Surgical infections (SSIs) are a type of hospital-acquired infection with life-threatening consequences for some patients. According to the latest insights from the Centers for Disease Control and Prevention, there were more than 110,000 SSIs similar to hospital surgeries in the United States. These infections cause a peak rate of morbidity and mortality, and a patient’s risk of death is estimated to be up to 11 times higher than normal. SSIs also have a very high monetary burden, with an average extended hospital stay of only about 10 days and additional hospitalization costs estimated at $20,000 depending on the patient.
There are several recommended protocols to help avoid SSIs, but poor patient adherence, high costs, and bacterial resistance can diminish their usefulness and effectiveness. In this new study, the researchers sought to compare the effects of a protocol designed to reduce SSIs. with a specific concentrate on the pathogen Staphylococcus aureus. The technique consisted of pre-surgical intranasal application of povidone iodine and cutaneous antisepsis with chlorhexidine gluconate (CHG).
The study included 688 adult patients who underwent hip or knee replacement or spine surgery at Soroka University Medical Center between February 2018 and October 2021. Its effects were observed in a retrospective cohort of patients from 2016 and 2017 treated before the povidone-iodine component of treatment. The protocol has been implemented. Patient outcomes were followed for 90 days after surgery.
Implementing this procedure prior to surgery has addressed a broad physical care challenge: approximately 30% of the population is colonized by S. aureus without symptoms. The presurgical protocol succeeded in eliminating S. aureus in approximately 40% of patients already harboring the pathogen.
This is especially important for patient outcomes, as researchers have found that the presence of S. aureus within one day of surgery is linked to a threefold risk of developing SSI. Overall, the study showed a significant reduction in severe SSI in patients who won the most recent protocol.
“Our study obviously shows that we can prevent surgical site infections and ensure patient protection by using an undisputed pre-surgical nasal application of povidone iodine in combination with a popular CHG bath,” said Lisa Saidel-Odes, MD, an infectious disease specialist at Soroka University Medical Center and leader of the paper. “We note that the protocol is most effective in cases where S. aureus is sparsely provided and recommend that increased application of povidone iodine is possibly mandatory for patients with greater nasal colonization. “
Additional highlights from the study:
“This study shows the strength of the widespread application of available antiseptics to reduce SSIs and patient safety,” said Tania Bubb, Ph. D. , RN, CIC, FAPIC, chair of APIC 2024. “The effects are encouraging not only because the regimen is effective in reducing SSIs, but also because it is undeniably effective in preventing the threat of antibiotic resistance. “
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