Effect of pre-operative octenidine nasal ointment and showering on surgical site infections in patients undergoing cardiac surgery

Autor: André Scherag, Magali Reiser, T Doenst, Christina Forstner, Stefan Hagel, Frank M. Brunkhorst, Mathias W. Pletz, Stéphan Juergen Harbarth
Rok vydání: 2017
Předmět:
Male
0301 basic medicine
genetic structures
Non-Randomized Controlled Trials as Topic
Pyridines
medicine.medical_treatment
Preoperative Care/methods
law.invention
Cohort Studies
Ointments
0302 clinical medicine
Randomized controlled trial
law
Pyridines/administration & dosage
030212 general & internal medicine
ddc:616
Thoracic Surgery
General Medicine
Ointments/administration & dosage
Middle Aged
Cardiac surgery
Infectious Diseases
Cardiothoracic surgery
Female
Imines
Cohort study
Microbiology (medical)
medicine.medical_specialty
Surgical Wound Infection/epidemiology/prevention & control
Infection Control/methods
030106 microbiology
Soaps
Preoperative care
03 medical and health sciences
Preoperative Care
medicine
Humans
Surgical Wound Infection
Administration
Intranasal
Aged
Infection Control
Anti-Infective Agents
Local/administration & dosage
business.industry
Odds ratio
eye diseases
Confidence interval
Surgery
Median sternotomy
Anti-Infective Agents
Local
sense organs
business
Zdroj: Journal of Hospital Infection, Vol. 95, No 2 (2017) pp. 137-143
ISSN: 0195-6701
DOI: 10.1016/j.jhin.2016.11.004
Popis: Summary Objective To evaluate the effect of pre-operative octenidine (OCT) decolonization on surgical site infection (SSI) rates. Design Before-and-after cohort study. Patients Patients undergoing an elective isolated coronary artery bypass graft (CABG) procedure: control group (1 st January to 31 st December 2013), N =475; intervention group (1 st January to 31 st December 2014), N =428. Interventions The intervention consisted of nasal application of OCT ointment three times daily, beginning on the day before surgery, and showering the night before and on the day of surgery with OCT soap. Results A median sternotomy was performed in 805 (89.1%) patients and a minimally invasive direct coronary artery bypass procedure was performed in 98 (10.9%) patients. Overall, there was no difference in SSI rates between the control and intervention groups (15.4% vs 13.3%, P =0.39). The rate of harvest site SSIs was significantly lower in patients in the intervention group (2.5% vs 0.5%, P =0.01). Patients who had undergone a median sternotomy in the intervention group had a significantly lower rate of organ/space sternal SSIs (1.9% vs 0.3%, P =0.04). However, there was a trend towards an increased rate of deep incisional sternal SSIs (1.2% vs 2.9%, P =0.08). Multi-variate analysis did not identify a significant protective effect of the intervention (odds ratio 0.79, 95% confidence interval 0.53–1.15, P =0.27). Conclusions Pre-operative decolonization with OCT did not reduce overall SSI rates in patients undergoing an elective isolated CABG procedure, but significantly decreased harvest site and organ/space sternal SSIs. Randomized controlled trials, including controlled patient adherence to the intervention, are required to confirm these observations and to determine the clinical utility of OCT in pre-operative decolonization.
Databáze: OpenAIRE
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