How can we improve patient outcomes in regard to surgical site infections?

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Preventing Infection after Hip and Knee Surgeries
Source: Institute for Healthcare Improvement (

Surgical site infections (SSIs) following hip or knee arthroplasty can be catastrophic for the patient —- leading to multiple surgeries, prolonged periods of medical and physical therapy, use of a wheelchair or walker, months of recuperation, significant pain, and substantial out-of-pocket expenses, reports the Institute for Healthcare Improvement , not to mention increased costs to providers.

Preventing Infection after Hip and Knee Surgeries

Three common practices reduce surgical site infections, reports the IHI.


With over 1.1 million procedures done in 2008 (the most recent numbers available), knee and hip replacements are two of the most commonly performed surgeries in the U.S. Depending upon patient risk, it is estimated that between 6,000 and 20,000 SSIs occur annually after these types of surgeries and the number is predicted to rise substantially in coming years due to an aging population staying more active, as published in Healthcare Executive.

The estimated economic impact of one infection is approximately $100,000 in hospital costs alone after hip arthroplasty and $60,000 after knee arthroplasty. This is three to four times the average cost of the initial surgery, and these excess costs are absorbed by hospitals, patients and payors.

Three practices that substantially reduce Surgical Site Infections, especially after hip and knee replacements

• Use of an alcohol-containing antiseptic agent for preoperative skin preparation

• Preoperative bathing or showering with chlorhexidine gluconate (CHG) soap for at least three days before surgery

• Staphylococcus aureus screening and use of intranasal mupirocin and CHG bathing or showering to decolonize Staphylococcus aureus carriers

Doing everything possible to reduce harm is obviously good for patients. It is also worth noting that improved outcomes also offer providers a way to distinguish themselves in an increasingly competitive market in which patients have more access to information (online, through word of mouth, etc.). Joint replacement surgeries are often elective, allowing patients the flexibility and time to “shop around” for providers.