Study: SSI bundle lowers the risk of infections for joint and cardiac surgeries

Patient Safety Monitor Insider

September 23, 2015

Surgical bundles have become commonplace in the healthcare industry, particularly to help stave off dangerous infections. A recent study looking specifically at cardiac procedures and joint replacement procedures shows that a previously untested surgical site infection (SSI) bundle can offer an additional element of prevention as hospitals strive to reduce infection rates.

The study, published in June by the Journal of the American Medical Association (JAMA), found that a bundled approach to SSI prevention in which patients who tested positive for methicillin-resistant staph aureus (MRSA) and methicillin-susceptible staph aureus (MSSA) applied mupirocin intranasally twice a day five days prior to surgery and bathed in chlorhexidine-gluconate for five days prior to surgery. The treatment can reduce complex SSIs anywhere from 40% to 75% depending on adherence. Patients that tested positive for MRSA or MSSA were also given vancomycin and cefazolin prior to surgery.

Loreen Herwaldt, MD, a professor of infectious diseases at the University of Iowa College of Medicine, a hospital epidemiologist at the University of Iowa Hospitals and Clinics in Iowa City, and the lead author of the study, said that elements of the bundle have been previously studied separately, but no one had looked at all of the elements bundled together.

"Staph aureus is a very common cause of infections for these procedures, and if these patients get infected, if it's a joint replacement, they could lose the joint," she says. "In the best case scenario, they could be treated for probably a couple of months with IV antibiotics. And you can imagine how serious an infection in the bone of the sternum or in the tissue around the heart could be. So the goal is to prevent those infections."

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