Is Preoperative Nasal Povidone-Iodine as Efficient and Cost-Effective as Standard Methicillin-Resistant...

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Health Economics

Background:

• Surgical site infections (SSIs) are a significant complication in total joint arthroplasty (TJA).
• Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen contributing to SSIs.
• Current MRSA screening methods can be costly and may not be the most effective preventative measure.

Purpose of the Study:

• To compare the efficacy and cost-effectiveness of nasal povidone-iodine (PVP-I) swabs versus traditional MRSA screening.
• To evaluate the incidence of 90-day postoperative SSIs in total knee and hip arthroplasty patients.

Main Methods:

• Single-center retrospective review of primary or revision total knee or hip arthroplasty patients.
• Comparison of infection rates between patients screened with nasal PVP-I swabs and those undergoing MRSA screening.
• Analysis of cost-effectiveness for both screening methods.

Main Results:

• Both nasal PVP-I swabs and MRSA screening demonstrated an equivalent infection rate of 0.8%.
• Nasal PVP-I swabs were significantly more cost-effective, with a mean cost of $27.21 compared to $121.16 for MRSA screens (P ≤ .01).
• No significant difference in 90-day postoperative SSI incidence was observed between the groups.

Conclusions:

• Nasal povidone-iodine swab antiseptic is a clinically successful and financially advantageous alternative for screening TJA patients.
• Implementing nasal PVP-I swabs can lead to substantial cost savings without compromising patient safety or infection control.
• This approach offers a viable strategy for reducing healthcare costs associated with SSI prevention in arthroplasty procedures.