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Market Trend: Reducing Surgical Site Infections

Market Trend:  Reducing Surgical Site Infections

Health care-associated infections (HAIs) are a costly issue facing many hospitals across the nation.  HAIs are infections that patients acquire during the course of receiving treatment for unrelated conditions.  Healthcare-associated infections can be devastating, and at times, fatal.  With approximately 300,000 occurrences each year, surgical site infections (SSIs) are the second most prevalent HAI in the United States, preceded only by urinary tract infections.  At a cost of approximately $10 billion annually, this high incidence of SSIs significantly impacts the U.S Healthcare System, as well as the bottom line of individual hospitals.1

As a supplement to the Deficit Reduction Act of 2005, which called for payment provisions for certain hospital-acquired conditions (HACs), Centers for Medicare and Medicaid Services (CMS) published the Inpatient Prospective Payment System (IPPS) Fiscal Year (FY) 2011 Final Rule.  The Final Rule discusses the HAC categories that will not be reimbursed, if not present on patient admission.  Specifically, surgical site infections following coronary artery bypass graft, various orthopedic procedures, as well as bariatric surgeries, will not be reimbursed.  Consequently, hospitals are highly motivated to implement protocols and procedures to minimize the risk of SSIs.3

The Center for Disease Control (CDC) has identified a few key causes of surgical site infections.

Pre/intra-operative risks include the decreased effectiveness of antibiotic prophylaxis due to the colonization and proliferation of resistant organisms, such as Methicillin-Resistant Staphylococcus Aureus (MRSA).  According to the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), in 2007 MRSA accounted for 50-70% of healthcare acquired staph infections.  In recent years, the prevalence of MRSA has become an increasing problem within both healthcare facilities, as well as the community.  APIC is concerned with the severity of healthcare-acquired MRSA, as it is less susceptible to antimicrobials, which can result in life-threatening health issues, such as SSIs.4

Consequently, hospitals are placing increased importance on the use of appropriate antimicrobial agents for preparing the surgical site.  Hospitals are also strictly enforcing the adherence to aseptic techniques, both preoperatively and intraoperatively, in an effort to reduce the risk of SSIs.  Surgical aseptic techniques include surgical hand scrubbing, instrument sterilization, as well as donning sterile surgical attire.  If not properly disinfected, bacteria laden hard surfaces can also result in SSIs.  Therefore, disinfecting hard surfaces and equipment with appropriate hospital grade disinfectant solutions is essential in SSI prevention.1

Postoperative risks include the inappropriate utilization of wound dressings.  The CDC recommends that all surgical sites are protected with a sterile dressing within 24-48 hours following surgery.1  To expedite healing and reduce the risk of SSIs:  hospitals should utilize sterile wound dressings with the following characteristics; protects against external contaminants, maintains a moist wound environment, allows gaseous and fluid exchange, does not adhere to the wound, is nontoxic and nonsensitizing, and is highly absorptive (if wound is likely to be highly exuding).5  In addition to proper wound dressing protocols, the utilization of antimicrobial wound dressings may further reduce the risk of SSIs.  

According to Dr. Liza Ovington Ph.D, CWS, a prominent wound care thought leader and research chemist, antimicrobial wound dressings impregnated with silver “provide a sustained release of positively charged silver ions at the wound surface.”  Dr. Ovington explains that this “can promote wound healing and decrease infection by killing bacteria.”6

Currently, hospitals are striving to reduce their SSI Standardized Incidence Ratios by at least 25% before 2014.2 With the increasing trend toward resistant organisms undermining the effectiveness of prophylactic antibiotics, hospitals can no longer rely solely on prophylactic antibiotics in the prevention of SSIs.  Rather, hospitals are now implementing alternative pre, intra, and post-operative prevention methods, to help reduce their Standardized Incidence Ratio of SSIs.1   

The adaptation of SSI prevention methods, and continued efforts to reduce SSI Standardized Incidence Ratios is likely to drive increased demand for topical antimicrobial agents, hard surface disinfectants, as well as encourage the utilization of appropriate surgical wound dressings.

Companies that are currently, or planning to compete within these product categories have a significant opportunity to benefit from market trends discussed above.

Please contact us today to learn how 3S Consulting Group can assist your organization excel within the high growth, infection prevention market.


References

1. Berríos-Torres, S.I. "Surgical Site Infection (SSI) Toolkit." Center for Disease Control and Prevention. Center for Disease Control and Prevention, 21 Dec. 2009. Web. 25 Jan. 2011. <http://www.cdc.gov/HAI/pdfs/toolkits/SSI_toolkit021710SIBT_revised.pdf>.

2. "HHS Action Plan to Prevent Healthcare-Associated Infections, Appendix G." HHS. United States Department of Health and Human Services, 22 June 2009. Web. 31 Jan. 2011. <http://www.hhs.gov/ash/initiatives/hai/11-hai-plan-appendices.pdf>.

3. "Hospital-Acquired Conditions in Acute Inpatient Prospective Payment System Hospitals." Centers for Medicare & Medicaid Services. Department of Health & Human Services, Oct. 2010. Web. 25 Jan. 2011. <https://www.cms.gov/HospitalAcqCond/downloads/HACFactsheet.pdf>.

4. Osmundsen, Jonathan. "National Prevalence Study of Methicillin-Resistant Staphylococcus Aureus." APIC. Association for Professionals in Infection Control & Epidemiology, Inc., 25 June 2007. Web. 26 Jan. 2011. <http://www.apic.org/Content/NavigationMenu/ResearchFoundation/PreviousStudies/NationalMRSAPrevalenceStudy/APIC_MRSA_STUDY_EXEC.pdf>.

5. Ruszczak, Zbigniew. "Surgical Dressings." Emedicine. WebMD, 15 Jan. 2009. Web. 26 Jan. 2011. <http://emedicine.medscape.com/article/1127868-overview>.

6. "What You Should Know About Using Silver Products In Wound Care." Podiatry Today. Ed. Lawrence Karlock. Podiatry Today, Nov. 2004. Web. 26 Jan. 2011. <http://www.podiatrytoday.com/article/3156>.