Surgical infection more likely in patients with history of skin infections

Patients are three times more likely to develop a surgical site infection during an operation when they have a history of single skin infections, according to research presented by Johns Hopkins University.

Researchers analyzed information on 613 patients before, during and after surgery between February 2007 and August 2010. Patients enrolled underwent cardiac surgery, vascular surgery, neurosurgery or spinal surgery and were followed for 6 months afterward.

Overall, 22% of patients had a history of skin infection; of those, 6.7% got a surgical site infection compared with 3.9% of patients without a history. Twenty-four patients developed a surgical site infection within 180 days of surgery; five patients died from the infection.

“What this research suggests is that people have intrinsic differences in how susceptible they are to infection and that we need to know their skin infection histories,” Nauder Faraday, MD, MPH, associate professor of anesthesiology and critical care medicine at Johns Hopkins University School of Medicine, said in a press release. “Now that we have these findings, we must learn more about the exact molecular basis for the difference and develop new strategies to prevent harm.”

Responsible for more than 10,000 deaths, disabilities and decreased quality of life, surgical site infections develop in an estimated 500,000 patients, according to the researchers. The Centers for Medicare and Medicaid Services (CMS) is starting to refuse to cover the costs of additional care related to these infections after some cardiac and orthopedic procedures because many are believed to be preventable.

“The problem with financial penalties instituted by CMS is that it implies we know everything about how to prevent surgical site infections and if we just do the right thing, we won’t have complications,” Faraday said. “There’s no doubt we can and should do better, but we won’t eliminate infections with the knowledge and treatments we have now. There’s still a lot to learn if we want to reach out goal of zero complications.”

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