NEW ORLEANS – Repeat skin antisepsis performed after surgical draping but before incise draping reduces the incidence of surgical site infection in patients who undergo total joint replacement, according to results of a study presented here.
“We believe that repeat skin antisepsis helps to remove contaminating organism that gain access to the surgical site during draping, and is significant for a 5-fold decrease in superficial surgical skin site infections,” Tiffany N. Morrison, MS, said at the American Academy of Orthopaedic Surgeons Annual Meeting.
In a randomized single-blinded, prospective study, Morrison and colleagues recruited 600 patients who underwent total joint arthroplasty (TJA) between March 2010 and November 2011 at a single center. Overall, 578 patients were eligible for randomization. Patients in the control group received standard skin preparation with chlorhexidine during a preoperative shower. Alcohol and betadine was also given during intraoperative skin preparation, followed by the surgical draping. The incise drape was applied once the skin dried.
Patients in the interventional group received an identical preparation of the skin, however, the researchers applied an additional skin preparation – an iodine povacrylex/alcohol combination – before the application of the incise drape.
Morrison said there were 19 superficial surgical site infections (SSI) in the control group with a 6.5% incidence of infection, whereas 5 patients in the interventional group had a superficial SSI with an incidence of 1.8%. The rate of skin blistering within 6 weeks postoperatively was 3.5% in the interventional group compared with 6.2% in the control group, although this difference was not significant, she said.
Morrison TN. Paper #49. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
Disclosure: Morrison has no relevant financial disclosures. The study was funded by 3M.