New England Journal of Medicine editorial authored by VCU expert
|
|
(HealthNewsDigest.com) – RICHMOND, Va. – Almost half of all surgical site infections that occur post-operatively can be prevented, according to an editorial by a Virginia Commonwealth University physician published in the Jan. 7 issue of the New England Journal of Medicine.
In the editorial, Richard P. Wenzel, M.D., professor and former chair of the Department of Internal Medicine in the VCU School of Medicine, examined two large multi-institutional studies published in the same issue of the journal and analyzed their combined impact for controlling surgical-site infections.
One study showed an approximately 40 percent reduction of all surgical-site infections in a group of patients who received a preoperative skin scrub with chlorhexidine-alcohol, compared to the standard povidone-iodine scrub. The second study focused on reducing infections caused by Staphylococcus aureus by eliminating nasal and skin carriage of the organism in surgical patients before the operations.
According to Wenzel, approximately 20 percent to 30 percent of surgical-site infections are caused by S. aureus, and more than half of these infections arise from endogenous, or naturally occurring, bacteria that already exist in a person.
Wenzel, who is also an epidemiologist, suggested that the infection prevention rate could be increased by an additional 7.5 percentage points if the S. aureus interventions were added to the new scrub interventions. With a combined approach, a total of 47.5 percent of surgical-site infections might be prevented, which translates to between 150,000 to 250,000 infections that could be prevented in the U.S. in a year, he said.
Wenzel called the first approach a “horizontal program” since infections caused by all organisms were reduced, including half of the S. aureus infections. The second approach he called a “vertical program” which focused on a single microbe – S. aureus.
“The weight of evidence suggests that chlorhexidine-alcohol should replace povidone-iodine as the standard for preoperative surgical scrubs,” summarized Wenzel.
“The approach of removing S. aureus among patients who are carriers could be reserved for high-risk procedures such as heart surgery, implant surgery or surgery in patients with defective immune systems,” he said.
For more, see www.vcu.edu.
Subscribe to our FREE Ezine and be eligible for Health News, discounted products/services and coupons related to your Health. We publish 24/7.
HealthNewsDigest.com
We videotape Press Conferences, produce SMT’s, VNR’s, B-rolls, PSA’s, – all with distribution: HealthyTelevisionProductions