2 preop steps reduce surgical site infections

Two simple preoperative procedures significantly reduced the risk of site infections in cardiac and other surgeries. The protocol, which was reported in Antimicrobial Resistance and Infection Control, saved the health system more than $1 million.

Elizabeth Bryce, MD, regional medical director for infection control at Vancouver Coastal Health in Vancouver, and colleagues looked at the use of preoperative decolonization therapies for reducing the incidence of surgical site infections. The study included a treatment group of 3,068 patients who received elective cardiac, orthopedic, spine, vascular, thoracic or neurology surgery procedures between Sept. 1, 2011, and Aug. 31, 2012. Patients were treated with chlorhexidone body wipes the night before surgery and intranasal antimicrobial photodisinfection therapy in the preoperative waiting room.

Patients were followed for a minimum of three months using a surgical site surveillance system that had had been in place and unchanged over many years. Outcomes were compared to a historical control group of 12,387 patients over a four-year period as well as a concurrent control group of 196 untreated patients.

The rate of surgical site infections for the treatment group was 1.6 percent vs. 2.7 percent in the historical control group. The risk of Staphylococcus aureus infection was higher in the concurrent untreated group, at 61 percent vs. 32 percent for the treated group. Bryce et al calculated that preventing infections had a cost avoidance of $1.14 million ($1.2 million Canadian), which could have paid for 140 more surgeries.

The study was presented as an abstract at the International Conference on Prevention and Infection Control, which was held June 25-28 in Geneva.