Effect of Mupirocin Dressings Versus Island Dressings on Surgical Site Infections in Elective Colorectal Surgery
| Status: | Completed |
|---|---|
| Conditions: | Infectious Disease |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/10/2019 |
| Start Date: | November 2015 |
| End Date: | December 2018 |
The Use of Mupirocin Dressings and Its Effect on Surgical Site Infections in Elective Colorectal Surgery: A Prospective, Randomized Controlled Trial
Infections at the site of surgical incisions (SSIs) are the most common infection among
surgical patients. Although all patients undergoing surgical procedures are at risk for
developing SSIs, colorectal surgery has had consistently had high rates of SSIs, ranging from
3-45%. These infections can increase the length of hospital stay, and increase the rate of
readmissions and costs.
Further research is needed to study the effects of mupirocin in general surgery. A recent
study compared colorectal SSI rates between mupirocin and standard gauze surgical dressings.
The results of this show that mupirocin has the greatest effect on reducing SSI rate when
compared to standard gauze dressings. However, these studies have not been performed in the
United States and have only been studied on a very specific patient population.
The purpose of this study is to assess the rate of infections at the surgical incision after
colorectal surgery when a mupirocin dressing is placed versus a standard gauze dressing
without mupirocin.
surgical patients. Although all patients undergoing surgical procedures are at risk for
developing SSIs, colorectal surgery has had consistently had high rates of SSIs, ranging from
3-45%. These infections can increase the length of hospital stay, and increase the rate of
readmissions and costs.
Further research is needed to study the effects of mupirocin in general surgery. A recent
study compared colorectal SSI rates between mupirocin and standard gauze surgical dressings.
The results of this show that mupirocin has the greatest effect on reducing SSI rate when
compared to standard gauze dressings. However, these studies have not been performed in the
United States and have only been studied on a very specific patient population.
The purpose of this study is to assess the rate of infections at the surgical incision after
colorectal surgery when a mupirocin dressing is placed versus a standard gauze dressing
without mupirocin.
Surgical site infections (SSIs) are the most common nosocomial infection among surgical
patients and are the third most common nosocomial infection among all hospitalized patients.1
Although all patients undergoing surgical procedures are at risk for developing SSIs,
colorectal surgery has consistently had high rates of surgical site infections, ranging from
3-45%. Numerous studies have shown the adverse effects of SSIs, including increased length of
hospital stay, morbidity, mortality, readmissions and costs. In a recent study analyzing
various surgical procedures, including colorectal operations, surgical site infection was
found to be the number one cause of unplanned readmission.
Studies have been performed showing that intranasal mupirocin may have a role in reduction of
SSI in cardiac and orthopedic surgery. However, there has been minimal investigation on the
effects of topical mupirocin in general surgery. A recent study from Spain compared
colorectal SSI rates between mupirocin dressings, silver-impregnated dressings, and standard
gauze surgical dressings. The results of this show that mupirocin has the greatest effect on
reducing SSI rate when compared to standard gauze and silver-impregnated dressings. However,
these studies have not been performed in the United States and have only been studied on
open, colorectal oncologic surgery.
The aim of this study is to compare mupirocin dressings to standard surgical dressings and
their respective SSI rates at a United States community hospital in patients undergoing
elective open and minimally invasive colorectal surgery.
A single-center prospective, randomized study will be performed. Patients who will undergo
elective colorectal surgery and consent to participate will be randomized (1:1) to one of the
following 2 treatment groups:
1. Island dressings until postoperative day (POD) #2 (which is current practice at
Gundersen Health System)
2. Mupirocin + island dressing until POD#5 Analysis of outcomes will include rate of SSI,
and 30-day morbidity and mortality.
patients and are the third most common nosocomial infection among all hospitalized patients.1
Although all patients undergoing surgical procedures are at risk for developing SSIs,
colorectal surgery has consistently had high rates of surgical site infections, ranging from
3-45%. Numerous studies have shown the adverse effects of SSIs, including increased length of
hospital stay, morbidity, mortality, readmissions and costs. In a recent study analyzing
various surgical procedures, including colorectal operations, surgical site infection was
found to be the number one cause of unplanned readmission.
Studies have been performed showing that intranasal mupirocin may have a role in reduction of
SSI in cardiac and orthopedic surgery. However, there has been minimal investigation on the
effects of topical mupirocin in general surgery. A recent study from Spain compared
colorectal SSI rates between mupirocin dressings, silver-impregnated dressings, and standard
gauze surgical dressings. The results of this show that mupirocin has the greatest effect on
reducing SSI rate when compared to standard gauze and silver-impregnated dressings. However,
these studies have not been performed in the United States and have only been studied on
open, colorectal oncologic surgery.
The aim of this study is to compare mupirocin dressings to standard surgical dressings and
their respective SSI rates at a United States community hospital in patients undergoing
elective open and minimally invasive colorectal surgery.
A single-center prospective, randomized study will be performed. Patients who will undergo
elective colorectal surgery and consent to participate will be randomized (1:1) to one of the
following 2 treatment groups:
1. Island dressings until postoperative day (POD) #2 (which is current practice at
Gundersen Health System)
2. Mupirocin + island dressing until POD#5 Analysis of outcomes will include rate of SSI,
and 30-day morbidity and mortality.
Inclusion Criteria:
- 18 years of age or older
- Elective Colorectal surgery
- Open and minimally invasive cases
- Partial and total Colon resections, Abdominoperineal resection, Low anterior
resections, Creation/takedown of colostomy, abdominal procedures for prolapse
Exclusion Criteria:
- Patients with known allergies to mupirocin
- Cases in which the skin was intentionally left open at the end of surgery (secondary
closure technique)
- Women who are pregnant or planning to become pregnant
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