Effect of preop decontamination protocol on SSIs in orthopedic implant patients

Surgical site infections (SSIs), commonly caused by methicillin-resistant Staphylococcus aureus (MRSA), are associated with significant morbidity and mortality, specifically in orthopedic patients who have hardware implanted.

In this study, researchers from Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, both in Houston, Texas, examined the effect of a decontamination protocol on SSIs in patients having elective orthopedic surgery with hardware implantation. The protocol consisted of the application of 2% chlorhexidine washcloths and 0.12% oral rinse the night before and morning of surgery and 5% intranasal povidone-iodine solution the morning of surgery.

A total of 709 patients (344 controls and 365 patients who were decolonized) were involved in the study.

The SSI rate in the intervention group was significantly lower than in the control group (1.1% vs 3.8%). Multivariate analysis identified MRSA decontamination as an independent predictor of not developing an SSI.

The data demonstrate a significant decrease in overall SSI rates in orthopedic patients after implementation of the decontamination protocol, the researchers concluded.

—Bebko S P, Green D M, Awad S S. Effect of a preoperative decontamination protocol on surgical site infections in patients undergoing elective orthopedic surgery with hardware implantation. JAMA Surg. 2015;150(5):391-395.

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