title: Is Preoperative Nasal Povidone-Iodine as Efficient and Cost-Effective as Standard Methicillin-Resistant Staphylococcus aureus Screening Protocol in Total Joint Arthroplasty?
abstract: The purpose of this study was to compare nasal povidone-iodine swab for total joint arthroplasty patients to methicillin-resistant Staphylococcus aureus (MRSA) screening on the incidence of 90-day postoperative surgical site infections in total knee and hip arthroplasties as well as the cost-effectiveness. This is a single-center retrospective review of primary or revision total knee or hip arthroplasty patients. There were 849 patients screened for MRSA and 1004 patients in the nasal swab groups, both with an infection rate of 0.8%. The mean cost for the nasal swab was $27.21 (SD, 0), significantly different (P ≤ .01) than the mean cost for MRSA screens, $121.16 (SD, 26.18). There were significant cost savings with no difference in infection rates; therefore, nasal povidone-iodine swab antiseptic is financially and clinically successful.
authors.affiliation: Greenville Health System, Greenville, South Carolina.
authors.forename: Erick G
authors.initials: EG
authors.lastname: Torres
authors.affiliation: Greenville Health System, Greenville, South Carolina.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Lindmair-Snell
authors.affiliation: Greenville Health System, Greenville, South Carolina.
authors.forename: Justin W
authors.initials: JW
authors.lastname: Langan
authors.affiliation: Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, South Carolina.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Burnikel
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000191:economics* / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics* / Q000379:methods; D002710:Chlorhexidine / Q000737:chemistry; D015331:Cohort Studies; D003140:Communicable Disease Control / Q000191:economics; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D055624:Methicillin-Resistant Staphylococcus aureus; D009297:Nasal Mucosa / Q000382:microbiology; D011206:Povidone-Iodine / Q000008:administration & dosage* / Q000627:therapeutic use; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000191:economics; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000191:economics
chemical_list: D000900:Anti-Bacterial Agents; D011206:Povidone-Iodine; D002710:Chlorhexidine
keywords: complication; cost; infection; total hip arthroplasty; total knee arthroplasty