Two Methods Help Prevent Infections After Surgery

Jan. 7 -- WEDNESDAY, Jan. 6 (HealthDay News) -- Two separate research teams report that surgery-related infections can be prevented using two different methods, one aimed at antibiotic-resistant Staphylococcus aureus growing in the nose, the other at microbes living on the skin.

While the skin-based approach was more efficient, and required fewer resources and less testing, both methods can be used together in some high-risk cases, said Dr. Rabih O. Darouiche, lead author of one of two reports in the Jan. 7 issue of the New England Journal of Medicine.

Infections are a common complication after surgery, with the incidence running as high as 5 percent for people undergoing very invasive procedures such as colon surgery or hip replacements. Attention has often been focused on those caused by drug-resistant S. aureus bacteria that can spread from their nasal base.

A trial aimed specifically at nasal staph halved the risk of such infections, physicians from Erasmus University Medical Center in Rotterdam, the Netherlands, report. Their trial started when 6,771 people admitted for surgery were screened for nasal staph; 1,251 were found to carry the germ.

Of these, 917 were put in a controlled trial, with half receiving no treatment aimed at staph and half getting two antibiotic treatments, mupirocin nasal ointment and chlorhexidine soap. Only 3.4 percent of those receiving treatment developed infections, compared to 7.7 percent of those left untreated. The incidence of infections in people undergoing deep-incision surgery was reduced by nearly 80 percent, the Dutch researchers found.

The approach used in the other program was much simpler, said Darouiche, a professor of medicine at Veterans Affairs Medical Center in Houston and director of the Center for Prostheses Infection at Baylor College of Medicine. Of the 849 study participants admitted for surgery in six hospitals, 409 had their skin prepared with chlorhexidine and alcohol, and 440 had their skin prepared with povidone and iodine.