Complications - InfectionPovidone-Iodine–Based Solutions for Decolonization of Nasal Staphylococcus aureus: A Randomized, Prospective, Placebo-Controlled Study
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Materials and Methods
After institutional review board approval, during the 15-month enrollment period (April 2014 through July 2015), 445 primary or revision total joint arthroplasty, femoroacetabular osteoplasty, pelvic osteotomy, and total shoulder arthroplasty patients, who met the study inclusion criteria were approached for study participation; of these, 16 were excluded because of same-day discharge, which prevented us from obtaining a 24-hour post-treatment sample from these patients (Fig. 1).
The following
Results
At baseline, 95 of 429 patients (22.1%) had a positive culture result for S. aureus, of which 13 (3%) had MRSA. Of the 95 patients with positive culture results for S. aureus at baseline, 29 were decolonized with off-the-shelf PI, 34 were treated with 5% PI-based SNA, and 32 were decolonized using saline swabs. At 4 hours post-treatment, of those with a positive baseline result, S. aureus culture result was positive in 52% off-the-shelf PI group (15 of 29), 21% SNA group (7/34), and 59% saline
Discussion
The increasing burden of SSI has led numerous societies and governmental organizations to seek effective strategies for prevention. The Centers for Disease Control and Prevention, for example, will soon be issuing updated guidelines for SSI prevention [25]. The financial burden that SSI poses on society is immense. The prevention of a single case of SSI can save $42,300 for hospitals, and overall prevention can reduce the length of hospitalization by 50% [23].
One strategy for reduction of SSI
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2021, World Journal of Otorhinolaryngology - Head and Neck SurgeryCitation Excerpt :Another emerging mitigation strategy is the use of topical providone-iodine solution (PVP–I) during surgery. Historically, PVP-I solution has been utilized to decrease pre-operative microbial burden prior to procedures.31 Since PVP-I solution has bacteriocidal and virucidal properties in vitro it is an ideal solution to apply topically to the oropharynx and nasopharynx.32
Tolerability and usability of 0.5% PVP-I gargles and nasal drops in 6692 patients: Observational study
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The study was funded by the institution and there was no industry funding for this study.
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2017.04.039.
ClinicalTrials.gov Identifier: NCT02652325 (Nasal swab study comparison of effectiveness of povidone-iodine versus saline versus 3M Skin and Nasal Antiseptic 5% povidone-iodine USP swabs for decolonizing intranasal MSSA/MRSA).