Impact of an antimicrobial-impregnated gauze dressing on surgical site infections including methicillin-resistant Staphylococcus aureus infections.
BACKGROUND
Surgical site infections (SSIs) are a common complication of surgery. Methicillin-resistant Staphylococcus aureus (MRSA) is a particularly troublesome infectious agent in this setting. SSIs contribute to increased morbidity and mortality, as well as increasing length of hospital stay and costs.


METHODS
Sterile plain gauze dressings were replaced institution-wide by a comparable sterile antimicrobial gauze dressing (AMD) impregnated with 0.2% polyhexamethylene biguaide. SSIs, and specifically MRSA-SSIs, were tracked for the 11-month periods before and after the dressing switch, using Centers for Disease Control and Prevention criteria.


RESULTS
Before the introduction of AMD, 101 SSIs occurred after 9372 surgical procedures (1.08%), 20 of which were identified as MRSA (0.21%). After introduction of AMD, 84 SSIs occurred after 10,202 surgical procedures (0.82%), representing a rate reduction of 24.07% (P = .035), with 11 identified as MRSA (0.11%), representing a reduction of 47.62% (P = .047). This reduction in SSIs represents an annual cost savings to the institution of $508,605.


CONCLUSIONS
A significant reduction in SSIs, and specifically MRSA-SSIs, resulted from a simple change from plain sterile gauze to a sterile comparable antimicrobial dressing. This change reduced morbidity and possibly mortality after surgery, shortened hospital stays, and reduced the costs of postsurgical care.
Mueller
Shawn Westadt
SW
Epidemiology Department, BryanLGH Medical Center, Lincoln, Nebraska, USA. shawn.mueller@bryanlgh.org
Krebsbach
Larry E
LE
D001458:Bandages; D001645:Biguanides / Q000627:therapeutic use*; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D004202:Disinfectants / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D015995:Prevalence; D013203:Staphylococcal Infections / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*
D001645:Biguanides; D004202:Disinfectants; C031233:polihexanide