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Scrubs and nasal ointments found to reduce rate of acquired surgical infection
Investigators studying these extra precautions showed they effectively minimized risk of infection.
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Physicians seeking to reduce their patients risk of infection following surgery or during hospital stays may want to consider using an antiseptic cleanser and methods for decolonizing Staphylococcus aureus nasal carriers.
Details of these proven approaches appeared in the New England Journal of Medicine.
One of the most common causes of adverse effects in health care are surgical wound infections, which occur in 30 to 40 patients per 1,000 operations performed, according to Eucomed, Europe’s medical technology agency.
“Excess mortality among patients contracting a surgical wound infection is 5%, and the cost of surgical infection is estimated at between $2.4 and $3.4 million annually for a typical hospital,” Hans Lundgren, chairman of the Eucomed Advanced Wound Care Group, said in a Eucomed press release.
Chlorhexidine-alcohol superior
The first NEJM study randomized 849 subjects to chlorhexidine-alcohol scrub or povidone-iodine scrub/paint prior to clean-contaminated surgery. Results of the intention-to-treat analysis showed the chlorhexidine-alcohol group had a significantly lower incidence of surgical-site infection than the povidone-iodine group.
Rabih O. Darouiche, MD, of the Michael DeBakey VA Medical Center in Houston, and colleagues at six hospitals analyzed surgical site antisepsis and found chlorhexidine-alcohol was more effective for superficial and deep incisional infections than povidone-iodine.
Reduce nasal colonies
In the second study, screening and decolonizing nasal carriers of S. aureus with mupirocin nasal ointment and chlorhexidine soap on admission to hospitals resulted in a 3.4% rate of S. aureus infections compared to placebo, which was associated with a 7.7% infection rate.
The researchers, who are from Erasmus University Medical Center in Rotterdam, The Netherlands and other European centers, used real-time polymerase-chain-reaction assay (PCR) to identify the S. aureus carriers.
Based on PCR array results, all the S. aureus strains identified were susceptible to methicillin and mupirocin.
“The effect of mupirocin-chlorhexidine treatment was most pronounced for deep surgical-site infections (relative risk, 0.21; 95% CI, 0.07 to 0.62),” according to the abstract, where the researchers concluded, “The number of surgical-site S. aureus infections acquired in the hospital can be reduced by rapid screening and decolonization of nasal carriers of S. aureus on admission.” – by Susan M. Rapp
References:
- Bode LG, Kluytmans JA, Wertheim HF, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010;362:9-17.
- Darouiche RO, Wall MJ Jr, Itani KM, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med. 2010;362:18-26.