How can you, as a health care provider select an effective skin antiseptic product?
And how can you do all this in a cost-effective way?
We know that surgical skin prepping is a critical step in reducing the risk of surgical site infection – but it may not be enough. There is rising concern that surgical site infections can be caused by bacteria in the nares of surgical patients and colonization with Staphylococcus aureus (S. aureus) is a well-documented risk factor. By reducing S. aureus in the nares before surgery, we can help reduce the risk of surgical site infection and other complications.
This is why we at 3M have developed an innovative product to reduce bacteria in the nares – 3M™ Skin and Nasal Antiseptic, (Povidone-Iodine Solution 5% w/w [0.5 available iodine] USP) Patient Preoperative Skin Preparation. Our product contains a 5% povidone-iodine solution that was specially formulated for use in the nose. A simple one-time application prior to surgery is sufficient to effectively reduce bacteria in your patients’ nares.
Here is what I think you may ask: “Why not just use a standard 10% povidone-iodine solution? It would be inexpensive and it even contains double the amount of iodine.” Good question, but in this case, more is not always better!
Even though off-the-shelf 10% povidone-iodine solution has been used for decades as an effective surgical skin prep, it may not be the product you should consider as a first choice for prepping of the nares. The unique environment of the nose with its constant build-up of mucus tends to wash out a standard povidone-iodine solution. This may make it difficult for you to achieve an effective and long-lasting reduction of bacteria in the nares of your patients.
The special formulation of 3M™ Skin and Nasal Antiseptic combines 5% povidone-iodine with a film-forming polymer that helps povidone-iodine adhere to the inner lining of the nose and, you guessed it, prevents it from being flushed out. The solution is also formulated to be pH-balanced. This makes it is less irritating and improves your patients’ comfort and acceptability.
But how can you be assured that our product works in the clinical setting; that our nasal antiseptic swabs are more effective than standard povidone-iodine?
A prospective randomized controlled clinical trial in 429 total joint arthroplasty patients was conducted to answer this question (Rezapoor et al., 2015). The patients were randomized into 1 of 3 groups, each receiving a different treatment to evaluate its efficacy in reducing S. aureus in the nares:
1) Off-the-shelf 10% povidone-iodine solution
2) 3M™ Skin and Nasal Antiseptic
3) Saline solution (control)
Baseline cultures were obtained and the nares were swabbed for culture again at 4 and 24 hours after treatment to determine the remaining S. aureus.
Our 5% povidone-iodine vs. 10% povidone-iodine study achieved the results we had expected – 3M™ Skin and Nasal Antiseptic was significantly more effective (p=0.003) at reducing S. aureus in the nares over the 4 hour time interval than standard 10% povidone-iodine solution. Standard povidone-iodine was similar in efficacy to the saline control.
The study results are visualized in the graph below.
These results at 4 hours demonstrate that 3M™ Skin and Nasal Antiseptic reduces S. aureus significantly better than standard 10% povidone-iodine solution to provide the assurance you need that by choosing 3M™ Skin and Nasal Antiseptic, you use the best products for your patients.
Here are some additional benefits of the 3M™ Skin and Nasal Antiseptic you may want to consider when selecting an antiseptic for the nares:
- The broad-spectrum, fast-acting povidone-iodine antiseptic fits easily into your preoperative process
- The film-forming formula was designed to work within one hour and maintain at least 12 hours of persistence (3M Study 05-011100)
- It is effective against antibiotic resistant strains of S. aureus (in vitro*) (3M Study 05-010944)
- No resistance has been shown (in vitro*) (3M Study 05-011322)
- Compliance is not an issue because you as the caregiver apply the solution to the patient’s nares
- The one-time application an hour before surgery makes the procedure very quick and easy
- Surgical site infections are associated with increased health care cost, so using an effective product to reduce nasal carriage of bacteria may be a cost-effective addition to your preoperative protocol
So, in summary, the 3M™ Skin and Nasal Antiseptic is the only 5% povidone-iodine product that has been shown in a clinical study to be significantly more effective in reducing S. aureus in the nares than standard 10% povidone-iodine. Due to the adherent polymer, the 5% povidone-iodine remains in the nares for a longer period, which explains the better efficacy of this product. This confirms what I had mentioned in the beginning – that more is not always better.
As you can see, by choosing the 3M™ Skin and Nasal Antiseptic as part of a comprehensive preoperative protocol, you can help to safely and effectively reduce the risk of surgical site infections in your patients – and all in a budget-conscious manner!
Rezapoor M, Nicholson T, Patel R, et al. Do iodine-based solutions differ in their effectiveness for decolonizing intranasal Staphylococcus aureus? Presented at the MSIS Annual Meeting, Cleveland, OH, August 2015.
3M Study 05-011100
3M Study 05-010944
3M Study 05-011322
*The clinical significance of in vitro data is unknown