Surgical Site Infections May Be Reduced by Emails, Texts to Patients: Study

New research suggests that the risk of surgical wound infections may be significantly reduced through the use of electronic messages to patients, such as emails and texts reminding them to conduct preoperative antiseptic showers. 

In a study published in the August issue of the medical journal for the American College of Surgeons, researchers found that patients who received either a text message, voicemail or email were more likely to adhere to preoperative instructions. They also had lower surgical site infection (SSI) rates.

Researchers from the Medical College of Wisconsin Milwaukee separated 80 participants into four preoperative skin antiseptic showering groups. Volunteers were first placed in two groups. The first group was instructed to take two antiseptic showers with chlorhexidine gluconate (CHG). The second group took three showers. Antiseptic showers were taken 24 to 48 hours before admission to the hospital.

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Patients were then divided into groups again, with some of the participants in both shower groups either receiving electronic reminders and no such alerts.

Groups that took three antiseptic showers and were not alerted electronically had a 67% reduction in the level of antiseptic on the skin than those that received the electronic alerts. Researchers also found a 66% reduction in antiseptic overall on the skin of patients who were not alerted to shower compared to those that received electronic reminders.

Patients were instructed to return to the lab three hours after the last shower to have their skin tested to determine the amount of residual CHG. Five different areas of the body were tested.

CHG antiseptic reduces the amount of microbes on the surface of the skin decreasing the risk of intraoperative wound contamination. In this case, researchers found it also decreases the risk of surgical site infections.

Dr. Charles E. Edmiston, lead author of the study, said patients who did not get alerts were significantly less compliant with pre-admission orders compared to those that received them.

“I think a study like this provides us with a tremendous opportunity to empower patients because it clearly makes them an intimate partner in the whole health care experience,” said Edmiston.

Of the various technologies used to alert the patient of the preoperative instructions, text messages were the most popular method among the volunteers. Nearly 80 % of patients preferred text messages to emails or voicemails.

Researchers hope this study will help develop a standardized process for pre-admission antiseptic showers for surgical patients.

Hospital Infections Are A Deadly, Expensive Problem

Prior data released by the U.S. Centers for Disease Control and Prevention (CDC) suggest that about one out of every 25 patients acquires an infection somewhere in the health care system. Approximately 400,000 surgical site infections occur each year, which contributes to the deaths of nearly 100,000 people annually.

Hospital acquired infections, such as surgical site infections, are considered preventable events, but cause the health care system nearly $10 billion every year.

Five major types of infections associated with hospital visits were reviewed, including central line-associated bloodstream infections, ventilator-associated pneumonia, surgical site infections, Clostridium difficile infections, and catheter-associated urinary tract infections.

Surgical site infections cost about $21,000 per patient and have the greatest financial impact on health care. Because of how often they occur, SSIs accounted for 33% of the total cost of hospital-acquired infections.


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