Aug 12, 2015

Continuing the Fight to Decrease Surgical Site Infections

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Orthopedic-surgery

The 25th annual Musculoskeletal Infection Society (MSIS) open scientific meeting recently convened in Cleveland, Ohio.  The mission of the Society is to advance knowledge in the field of study of musculoskeletal infection and its treatment by education of the clinician and research members, education of the medical community, and promotion and maintenance of professional standards in order to provide the best professional care to patients with musculoskeletal infections.  The majority of the society members are orthopaedic surgeons, infectious disease specialists, and other healthcare providers who manage the care of patients with musculoskeletal infections.  Although the group is relatively small, they are clearly passionate about preventing and treating periprosthetic infection and do an excellent job of sharing and discussing the results of their research and identifying areas for collaboration.  One example of collaboration is that the society invited John Alverdy, MD, the current president-elect of the Surgical Infection Society, to speak at the meeting.  Dr. Alverdy gave a thought-provoking talk on the human microbiome and musculoskeletal infections that provided great insight into possible contributing factors for the development of infection.

Since I started attending this meeting a few years ago, one consistent topic has been nasal colonization of Staphylococcus aureus as a risk factor for periprosthetic infection.  There is increasing evidence that suggests decolonization of S. aureus may reduce the risk of surgical site infections and it is possible, if not likely, that this evidence could lead to increased use of the antibiotic mupirocin.

The healthy debate continues regarding screening surgical patients to identify S. aureus carriers versus universal treatment without prescreening.  Surgeons need to balance the desire to decrease the risk of postoperative infection while taking into account the concern of increasing antimicrobial resistance.

Scientists at 3M identified the need to address the problem of nasal S. aureus carriage in surgical patients while not adding to the issue of antimicrobial resistance.  3M™ Skin and Nasal Antiseptic  (Povidone-Iodine Solution 5% w/w [0.5% available iodine] USP) Patient Preoperative Skin Preparationis a 5% povidone-iodine formulation specifically developed by 3M to address the rising concern of surgical site infections caused by bacteria, including S. aureus, in the nares.  This product was introduced in 2010 and over the past few years there is mounting clinical evidence on the use of the product as part of a comprehensive preoperative protocol to help fight against surgical site infections.

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