Comparison of Efficacy and Cost of Iodine Impregnated Drape vs. Standard Drape in Cardiac Surgery: Study in 5100 Patients

Abstract

We sought to examine the efficacy in preventing surgical site infection (SSI) in cardiac surgery, using two different incise drapes (not iodine-impregnated and iodine-impregnated). A cost analysis was also considered. Between January 2008 and March 2015, 5100 consecutive cardiac surgery patients, who underwent surgery in our Institute, were prospectively collected. A total of 3320 patients received a standard not iodine-impregnated steri-drape (group A), and 1780 patients received Ioban(®) 2 drape (group B). We investigated, by a propensity matched analysis, whether the use of standard incise drape or iodine-impregnated drape would impact upon SSI rate. Totally, 808 patients for each group were matched for the available risk factors. Overall incidence of SSI was significantly higher in group A (6.5 versus 1.9 %) (p = 0.001). Superficial SSI incidence was significantly higher in group A (5.1 vs 1.6 %) (p = 0.002). Deep SSI resulted higher in group A (1.4 %) than in group B (0.4 %), although not significantly (p = 0.11). Consequently, the need for vacuum-assisted closure (VAC) therapy use resulted 4.3 % in group A versus 1.2 % in group B (p = 0.001). Overall costs for groups A and B were 12.494.912 € and 11.721.417 €, respectively. The Ioban(®) 2 offered totally 773.495 € cost savings compared to standard steri-drape. Ioban 2 drape assured a significantly lower incidence of SSI. Additionally, Ioban(®) 2 drape proved to be cost-effective in cardiac surgery.

Prevention of periprosthetic joint infection

“…52,53 NICE recommend the use of iodine impregnated drapes, 9 and recent studies support their use. 51,54 Nevertheless, the issue regarding the use of draping the area of the incision in general and the need for draping with bactericidal or bacteriostatic agents remains unresolved. A recent prospective, randomised study on 96 patients undergoing joint preservation surgery noted that the rate of skin contamination was significantly higher in patients without a drape in place compared with those with a drape (12.5% versus 27%, OR 2.48).…”

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

“…This was due to reduction in the costs related to the treatment of complications, such as use of vacuum-assisted closure (VAC) therapy, hospitalization days, sternal wound revision, antibiotic therapy, and use of antiseptics. 46 Following the basic surgical principles and proper vein harvest site selection are the most important factors for preventing leg wound infection, more so in patients with compromised lower extremity circulation. It is important to correctly track the course of SV.…”

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Use of Administrative and Surveillance Databases

“…In healthcare epidemiology, many studies have measured increased or attributable costs related to HAI, 12,[54][55][56][57][58][59][60] while others have evaluated the cost or cost-effectiveness of interventions. [61][62][63][64][65] A recent study utilized several different administrative datasets to estimate the potential cost-benefit of CDI reduction. 66 In any attempt to analyze costs of infections or of their prevention, an understanding of charges versus actual costs is critical.…”

“…Lastly, because billing is such an important component of many administrative datasets, studies attempting to determine costs or cost-effectiveness usually rely on administrative data. In healthcare epidemiology, many studies have measured increased or attributable costs related to HAI, 12 , 54 – 60 while others have evaluated the cost or cost-effectiveness of interventions 61 65 A recent study utilized several different administrative datasets to estimate the potential cost-benefit of CDI reduction 66 .…”