Surgical Site Infection Prevention - Fight surgical site infections from every angle

Manage SSI Risk Factors

  • The patient’s skin is the biggest risk factor for SSIs

    Take on the biggest risk factor for SSIs—the patient’s skin.

    Contamination from the patient’s own skin is the #1 cause of surgical site infections.1,2 Take control by implementing a combination of antimicrobial skin prep and iodine-impregnated incise drapes to reduce contamination around the surgical site.3


Review Clinincal Studies

  • Surgeries using iodophor/alcohol-based surgical preps, including 3M™ DuraPrep™ Surgical Solution (Iodine Povacrylex [0.7% available iodine] and Isopropyl Alcohol, 74% w/w) Patient Preoperative Skin Preparation, had a significantly lower SSI rate than surgeries using ChloraPrep™ Skin Prep.4 

    Another study showed:

    - DuraPrep Surgical Solution demonstrated resistance to removal by saline-soaked gauze (ρ<.0001).5

    - DuraPrep Surgical Solution suppresses regrowth of bacteria for at least 48 hours** with and without a blood and saline challenge.5

    Download the clinical evidence summaries if you want more details about how DuraPrep Surgical Solution helps reduce the risk of SSIs and resists wash-off.

  • In a study published in 2015, Ioban 2 Antimicrobial Incise Drapes were associated with lower SSI risk and reduced cost when compared to a non-antimicrobial incise drape in cardiac surgery.6

    Ioban 2 Antimicrobial Incise Drape were:
     

    • associated with a significant reduction in the incidence of overall SSIs (P = .001).6
    • shown to have an SSI rate of 1.9% vs 6.5% for the group that received a non-antimicrobial incise drape (a 71% SSI reduction rate).6
    • shown to be cost effective for direct patient-related care, delivering overall cost savings of $828,000 or $1025 per patient.6

    Download the clinical evidence summaries if you want more details about how Ioban 2 Antimicrobial Incise Drapes kill microbes in the deepest layers of skin and can help reduce the risk of wound infection.

SSI Risk Factor Equation

There are three variables, as demonstrated by the Centers for Disease Control and Prevention (CDC) formula below, that contribute to the risk of SSIs. Reducing a patient’s microbial load is critical to reducing the risk of SSIs.

  • Click hotspots above to learn more
    Click hotspots above to learn more

Patient risk factors

Where you have some control

Virulence of bacteria

Where you have the least control

Dose of bacteria

Where you have the most control

Microbial contamination on the skin

If we can reduce the number of microorganisms on the skin, we can reduce the risk of infection.

  • Trillions - SSIs are caused by microbial contamination

    The human body is covered in trillions of microbes.⁷

  • 100,000 - Microbes on human skin lead to SSIs

    The skin can contain over 1 million bacteria per square centimeter.⁸

  • 10 - Reduce skin microbes to reduce risk of contamination

    It only takes 10 microbes per square centimeter* to cause an SSI.⁹

    *when implant is present


It starts with the proper prep…

A proper skin prep reduces a patient’s bacterial load throughout the perioperative process, providing both immediate and lasting protection. But not all preps perform the same during surgery. Some preps can be removed during surgery by saline irrigation, dabbing with sponges or gauze, or contact with bodily fluids.

Proper surgical skin prep  – if the surgical prep is removed during the surgery, patients lose the critical protection of the active ingredient
  • 3M Prep Protection Film

    If surgical prep is removed during surgery, patients may lose the critical protection of the active ingredient.

    3M™ DuraPrep™ Surgical Solution (Iodine Povacrylex [0.7% available iodine] and Isopropyl Alcohol, 74% w/w) Patient Preoperative Skin Preparation was formulated with 3M™ Prep Protection Film, which dries to form a persistent and durable layer of protection on the patient’s skin to protect the prep from removal during surgery.10


…but sometimes preps alone are not enough.

While skin prep antiseptics reduce microbes, they do not eliminate all skin flora. An incise drape creates a physical barrier to prevent objects like instruments, gloves and sponges from coming into contact with the patient’s skin and transporting residual skin microbes to the surgical incision, which could result in a costly and potentially devastating SSI. Iodine-impregnated antimicrobial drapes not only immobilize residual microbes but kill microbes that migrate to the skin’s surface from the deeper skin layers and hair follicles.11,12


Skin preps don't work here

CHG doesn't work below a depth of 300 microns.

Iodine in deeper skin layers

3M™ Ioban™ 2 Antimicrobial Incise Drape creates a sterile barrier, and iodine from the drape has been shown to be present in the deeper skin layers.11,12

  • Clinical evidence on SSI prevention

    Review the clinical evidence

    In a study published in 2015, 3M™ Ioban™ 2 Antimicrobial Incise Drape was associated with lower SSI risk and reduced cost when compared to a non-antimicrobial incise drape in cardiac surgery.13

    In addition, a recent ex vivo study on human skin showed the iodine in Ioban 2 Antimicrobial Incise Drape was present at concentrations effective against MRSA at a depth of 1,000 microns, in the deeper layers of the skin, where hair follicles are present.12


Myths and truths about surgical preps and surgical drapes

  • Myth: All surgical preps work the same way.

    Reality: Not only do different preps have different ingredients that can impact efficacy, but how a prep performs in surgery is also important. Many preps are prone to washing off during surgery, meaning patients are losing critical protection from the active ingredient. DuraPrep Surgical Solution contains 3M™ Prep Protection Film, a unique polymer technology that protects the prep from removal during surgery.

  • Reality: While antiseptics reduce microbes, they primarily work on the skin surface and not in the deeper layers of skin. Incise drapes create a sterile barrier on top of the skin to help prevent residual bacteria from being transferred into the incision.11 Antimicrobial incise drapes, like Ioban 2 Antimicrobial Incise Drapes, kill residual bacteria on the skin.12 And when it comes to costs, a recent study has shown that the use of Ioban 2 Antimicrobial Incise Drapes can reduce costs for hospitals by over $1,000 per patient.13

  • Reality: According to an in vitro time-kill study, not all incise drapes are created equally. The study measured the antimicrobial activity of three different antimicrobial incise drapes. And while all drapes showed efficacy, at no time did any of the other drapes kill more organisms than Ioban 2 Antimicrobial Incise Drapes.14


Surgical skin prep

Antimicrobial incise drapes


References

  • 1. Reichman DE, Greenberg JA. Reducing surgical site infections: a review. Rev Obstet Gynecol. 2009;2:212-21.

    2. Cheadle WG. Risk factors for surgical site infection. Surg Infect. 2006;7(s1):s7-s11.

    3. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999; 20:247-78.

    4. Swenson BR, Hedrick, TL, Metzger R, Bonatti H, Pruett TL, Sawyer RG. Effects of preoperative skin preparation on postoperative wound infection rates: a prospective study of 3 skin preparation protocols. Infect Control Hosp Epidemiol. 2009;30:964-71.

    5. Stahl JB, Morse D, Parks PJ. Resistance of antimicrobial skin preparations to saline rinse using a seeded bacteria model. Am J Infect Control. 2007;35:367-73.

    6. Bejko J, Tarsia V, Carrozzini M, et al. Comparison of efficacy and cost of iodine impregnated drape vs. standard drape in cardiac surgery: study in 5100 patients. J Cardiovasc Transl Res. 2015;8:431-7.

    7. Human Microbiome: FAQ. American Society for Microbiology Academy Web site. https://www.asm.org/images/stories/documents/FAQ_Human_Microbiome.pdf. (PDF, 4.45 MB) 2013. Accessed March 23, 2017.

    8. Percival SL, Emanuel C, Cutting KF, Williams DW. Microbiology of the skin and the role of biofilms in infection. Int Wound J. 2012;9:14-32.

    9. Feldman G, Fertala A, Freeman T, et al. Recent advances in the basic sciences: osteoarthritis, infection, degenerative disc disease, tendon repair and inherited skeletal diseases. In: Austin MS, Klein GR, ed. Recent Advances in Orthopedics. 1st ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2014:256.

    10. Roberts AJ, Wilcox K, Devineni R, Harris RB, Osevala MA. Skin preparations in CABG surgery: a prospective randomized trial. Comp Surg. 1995;14:724, 741-7.

    11. French MLV, Eitzen HE, Ritter MA. The plastic surgical adhesive drape: an evaluation of its efficacy as a microbial barrier. Ann Surg. 1976; 184: 46-50.

    12. Casey AL, Karpanen TJ, Nightingale P, Conway BR, Elliott TSJ. Antimicrobial activity and skin permeation of iodine present in an iodine-impregnated surgical incise drape. J Antimicrob Chemother. 2015;70:2255-60.

    13. Bejko J, Tarzia V, Carrozzini M, et al. Comparison of efficacy and cost of iodine impregnated drape vs. standard drape in cardiac surgery: Study in 5100 patients. J Cardiovasc Trans Res. 2015;8:431-7.

    14. Eyberg CE, Morse DJ, Olson LK, Parks PJ. An in vitro time-kill study to compare the antimicrobial activity of three antimicrobial surgical incise drapes. Poster presented at; 19th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America (SHEA); March 2009; San Diego, CA.

    **following ASTM E1173

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