Surgical site infections (SSIs) pose a significant risk in the healthcare sector, increasing the likelihood of patient death by up to 11 times compared to those who do not contract an SSI. These infections not only lead to higher morbidity and mortality rates but also impose a considerable financial strain due to the prolonged hospital stays and additional costs incurred. Although various protocols have been recommended to counter SSIs, challenges such as patient non-compliance, escalating costs, and bacterial resistance often diminish their effectiveness. Now, a new study has demonstrated the effectiveness of a simple pre-surgical infection prevention protocol in reducing dangerous post-surgical infections.

In this new study, researchers at Soroka University Medical Center (Beersheba, Israel) evaluated the results of a protocol designed to minimize SSIs, particularly those caused by the Staphylococcus aureus bacterium. This protocol included administering povidone-iodine intranasally and applying chlorhexidine gluconate (CHG) on the skin before surgery. The study analyzed 688 adults who underwent hip or knee arthroplasty, or spinal surgery at the medical center from February 2018 to October 2021. Their post-surgical outcomes were then compared with those of patients from 2016 and 2017, prior to the introduction of povidone-iodine into the protocol. Monitoring was conducted for 90 days post-operation to evaluate the protocol's effectiveness.

Deploying this intervention prior to surgery helped to address a broad challenge in healthcare, that some 30% of the population is colonized with S. aureus without exhibiting symptoms. Remarkably, the protocol eradicated the S. aureus bacterium in nearly 40% of the patients who were carriers before surgery. The significance of removing S. aureus was underscored by findings that its presence shortly after surgery tripled the risk of SSI development. The introduction of this protocol led to a marked reduction in the occurrence of serious SSIs, highlighting its potential to significantly improve patient safety and outcomes in surgical settings.

“Our study clearly shows that we can prevent surgical site infections and keep patients safer through the use of a simple pre-surgical nasal application of povidone-iodine in combination with standard CHG bathing,” said Lisa Saidel-Odes, MD, Infectious Diseases specialist at Soroka University Medical Center. “We noted that the protocol is most effective in cases with little S. aureus present and suggest that an additional application of the povidone-iodine might be needed for patients with greater nasal colonization.” 

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