Surgical Site Antisepsis
In February, the Medical Executive Committee formulated several plans to decrease nosocomial infections at Banner Gateway Medical Center. As part of this initiative, a team to standardize our surgical site antisepsis was created. Since the patient’s skin is a major source of pathogens that cause surgical-site infections, optimization of preoperative skin antisepsis will decrease postoperative infections.
There are several studies, including the landmark 2010 New England Journal of Medicine study, that support the use of chlorhexidine-alcohol versus povidone-iodine in reducing surgical site infections within 30 days after surgery. We have taken this evidence based literature and made the recommendation to develop chlorhexidine-alcohol as the single surgical site antisepsis for the majority of surgical procedures at Banner Gateway. However, there are a few surgical procedures in which povidone-iodine is warranted. This process is being reviewed and your input is welcome. Additional information regarding our plan to phase out povidone-iodine products will be communicated to you once it is finalized. Penny Boone, Director Perioperative Services, will be looking at the surgical prep process and will determine all the areas/prep kits in which this conversion will need to take place. Additional education will also be conducted with all perioperative staff regarding the proper use of chlorhexidine-alcohol scrub in the surgical prep process.
The final conversion will take place August 1, 2010. After this date - povidone-iodine will only be available on a limited basis and only for those surgical procedures or patient population defined by the sub-committee. Thank you in advance for your cooperation as we move forward with this initiative.