Outpatient Surgery Magazine

The Secret of Gritflowness - October 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/1295122

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Page 33 of 75

3 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 2 0 Understanding Your Nasal Decolonization Choices Treating the nares is a vital component of a multifaceted SSI prevention approach. S urgical site infections (SSIs) are expensive adverse events for surgical facilities, especially with procedures like total joint replacements and complex spine cases. While SSI risk is very low, complications are devastating for everyone involved. An implant infection is quite sig- nificant because typically the implant must be removed, so it becomes a costly multiple-stage procedure and the patient may not emerge with a good result. It's important, then, to realize that the simple adminis- tration of nasal decolonization before surgery is an extremely inex- pensive preventative intervention. If the patient is colonized with S. aureus, the nares are far and away the most common site. The problem right now is a lack of consensus on what the most effective and reliable nasal decolonization regimen actually is. Four major buckets of therapies enjoy at least some peer-reviewed data to suggest potential efficacy and use. Mupirocin is the traditional treat- ment. Nasal povidone-iodine (PI) is a distant second in terms of num- ber of publications, followed by nasal alcohol-based preps and photo- dynamic therapy. Given the limited peer-reviewed information on the true efficacy of the mupirocin alternatives, it's too early to say which is the best. Here, we'll take a closer look at all four in the hopes of bet- Edward Septimus, MD | Houston JUST A DAB Using povidone-iodine as a nasal decoloniza- tion agent allows you to eliminate the several days of at- home patient compliance associated with mupirocin.

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