Single vs Repeat Surgical Skin Preparations for Reducing Surgical Site Infection After Total Joint Arthroplasty: A Prospective, Randomized, Double-Blinded Study
Abstract
Preventing surgical site infection (SSI) after total joint arthroplasty (TJA) is a high priority and is partly linked to the efficacy of surgical site preparation solutions (SPSs) in reducing the number of pathogens on the skin before incision. The aim of this study is to investigate the effectiveness of SRS reapplication after draping to reduce the incidence of SSI after TJA. Six hundred patients undergoing primary TJA between 2010 and 2011 at a single institution were recruited and randomly assigned to one of 2 groups. The patients in the intervention group (n = 300) received SPS that included alcohol and povidone-iodine before draping and an additional SPS by iodine povacrylex and isopropyl alcohol before application of the final adhesive drape, whereas the patients in the control group (n = 300) received a single SPS with alcohol and povidone-iodine before draping. Randomization was performed by an opaque envelope, and the rates of SSI and blistering were compared between groups. Five seventy-seven patients completed the study and were included in the final analysis. There was a significant reduction in the incidence of superficial SSI for the intervention group (1.8%, 5 of 283) compared to the control group (6.5%, 19 of 29...Continue Reading
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