Evidence-based care bundles minimized bacterial load, maximized methicillin-resistant Staphylococcus aureus protection and significantly reduced surgical site infection rates without topical vancomycin powder in high-risk spinal instrumentation cases, according to a study in Spine.
About half of all SSIs are preventable using evidence-based methods. Researchers screened patients scheduled for spinal instrumentation surgeries at a single tertiary referral hospital for high SSI, surgical and MRSA colonization risks. For high-risk patients, evidence-based care bundles were implemented, which included:
- Additional vancomycin prophylaxis
- Diluted povidone-iodine irrigation
- Nasal and body decontamination
There were 1,042 spinal instrumentation surgeries performed between November 2010 to December 2015 at the hospital, of which 301 were performed after the care bundles were implemented. Of the 301 surgeries, 18.9 percent of cases received care bundles.
The SSI rate decreased from 3.8 percent to 0.7 percent after the care bundles were implemented, with an overall 82 percent relative risk reduction. There were no MRSA-related SSIs among patients who received care bundles, even though MRSA was the predominant pathogen in the study population.