Researchers Find Large Variation in Surgical Prep in Patients With Open and Closed Fractures

Article

Surgically-managed fractures, particularly open fractures, are associated with high rates of surgical site infections (SSIs). To reduce the risk of an SSI, orthopedic surgeons routinely clean open fracture wounds in the emergency department (ED) and then apply a bandage to the open wound. Prior to the surgical incision, it is standard practice to prepare the fracture region with an antiseptic skin solution as an additional SSI prevention strategy. Multiple antiseptic solutions are available.

Jurado-Ruiz, et al. (2018) sought to explore the variation in practice patterns among orthopedic surgeons regarding antiseptic solution use in the ED and antiseptic preparatory techniques for fracture surgery. They developed a 27-item survey and surveyed members of several orthopedic associations.

Two hundred and-ten surveys were completed. 71.0% of respondents irrigate the open wound and skin in the ED, primarily with saline alone (59.7%) or iodine-based solutions (32.9%). 90.5% of responders indicated that they dress the open wound in the ED, with 41.0% applying a saline-soaked bandage and 33.7% applying an iodine-soaked dressing (33.7%). In their surgical preparation of open fractures, 41.0% of respondents used an iodine-based solution, 26.7% used a chlorhexidine gluconate (CHG)-based solution, and 31.4% used a combination of the two. In closed fractures, 43.8% of respondents used a CHG-based solution, 28.1% used an iodine-based solution, and 27.1% used a combination. Despite theoretical concerns about the use of alcohol in open wounds, 51.4% used alcohol-based solutions or alcohol alone during skin preparation of open fractures.

The researchers conclude that a lack of consensus exists regarding use of antiseptic surgical preparation solutions for fractures. High-quality clinical research is needed to assess the effectiveness of different surgical antiseptic preparation solutions on patient outcomes in fracture populations.

Reference: Jurado-Ruiz M, et al. Large variations in the practice patterns of surgical antiseptic preparation solutions in patients with open and closed extremity fractures: a cross-sectional survey. Antimicrobial Resistance & Infection Control. 2018;7:148
 

Recent Videos
Meet Shannon Simmons, DHSc, MPH, CIC.
Clostridioides difficile  (Adobe Stock 260659307 by gaetan)
Weekly Rounds with Infection Control Today
Association for Professionals in Infection Control and Epidemiology  (Image credit: APIC)
Patient Safety: Infection Control Today's Trending Topic for March
Infection Control Today's Trending Topic for March: Patient Safety
Infection Control Today® (ICT®) talks with John Kimsey, vice president of processing optimization and customer success for Steris.
Picture at AORN’s International Surgical Conference & Expo 2024
An eye instrument holding an intraocular lens for cataract surgery. How to clean and sterilize it appropriately?   (Adobe Stock 417326809By Mohammed)
Related Content