687. Prevention of Surgical Site Infections: Combined Use of Oxidized Cellulose and Povidone Iodine
Session: Poster Abstract Session: Skin, Soft Tissue and Joint Infections
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • POSTER IDSA TOUATI 2.pdf (999.1 kB)
  • Background:

    Despite the scrupulous respect of the different steps of skin preparation, and despite the introduction of iodine skin adhesive films, surgical site infections (SSI) persist and predominate in high risk patients. The stretching of these films often associated with detachment from the banks of the incision, coupled with maceration and bleeding from the surgical site may promote colonization of the incisional site and increase the risk of SSI. This area, highly critical is  usually "protected" by a surgical drape, which is in most centers, a simple sterile woven drape, disposable with no antibacterial activity. Based on encouraging in vitro data, the purpose of our study is to retrospectively analyze the efficacy and safety of the combination of oxidized cellulose (OC) and povidone iodine (PVI) on the margins of surgical incision.

    Methods: 

    From March 1993 to April 2011, 4520 consecutive patients (pts) operated by sternotomy, have benefited on the banks of the incision and the bone slices applying a OC gauze and a single-use margin drape impregnated with PVI. The only exclusion criteria was cutaneous hypersensitivity to iodine. At the end of surgery, the gauze of OC was removed, and surgical closure was performed. This cohort of patients was comprised of 2792 pts (62%) in the NNIS-0, 1187 pts (26%) in the NNIS-1, 468 pts (10%) in the NNIS-2 and 73 pts (2%) in the NNIS-3. 

    Results: 

    No intraoperative or postoperative allergic reactions was observed.

    The overall rate of SSI was for all groups of 0.75% (34pts) ; only 5 patients presented an organ/space SSI (0,11%) and 29 patients a deep incisionnal SSI (0,64%). All these patients required further surgery for debridement, irrigation and closed suction drains, combined with appropriate antibiotic therapy. Two thirds of these were due to ISO Gram negative. The SSI rates varied little according to the different NNIS groups. Mortality of this infected group was low (3/34 - 8%).

    Conclusion: 

    Despite the low significance of a nonrandomized, retrospective study, the results of the protection on the banks of incision, during the operative time, of oxidized cellulose associated with PVI are encouraging and confirm the observed in vitro study. Prospective randomized studies are needed to confirm these results.


    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Gilles Touati, M.D., Ph.D., Cardiac Surgery, South University Hospital, Amiens, France, Misbaou Barry, M.D., Ph.D., cardiac Surgery, south University Hospital, amiens, France, M Belmekki, m.D., South University Hospital, Amiens, France, M. Biendo, M.D., Microbiology, South University Hospital, amiens, France and Philippe Strohl, Ph.D., Institut de Recherche Microbiologique, Mitry Mory, France

    Disclosures:

    G. Touati, None

    M. Barry, None

    M. Belmekki, None

    M. Biendo, None

    P. Strohl, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.