Comparison of Cost Savings of Methods of Prevention of Orthopedic Implant-Associated Infection in Arthroplasty and Closed Fracture Surgery Patients
<b>Background/Objectives</b>: Surgical site infections (SSIs) are serious complications in orthopedic implant-associated procedures, increasing morbidity, mortality, and hospital costs. The purpose of this study was to evaluate the impact of a structured infection prevention and control (IPC) service on SSI incidence and cost savings across hip arthroplasty (HA), knee arthroplasty (KA), and open reduction and internal fixation (ORIF). <b>Methods</b>: A retrospective analysis included 6930 patients treated between 2019 and 2024, divided into pre-intervention (2019-2022) and post-intervention (2023-2024) cohorts. Preventive methods (PMs) comprised enhanced antibiotic prophylaxis, Staphylococcus aureus screening, chlorhexidine bathing, intraoperative audits, and behavioral interventions. Economic evaluation used literature-based costs, standardized to 2024 US dollars (USD 2024), with sensitivity analyses performed. <b>Results</b>: SSI incidence decreased from 5.6% to 1.1% overall (<i>p</i> < 0.001), with consistent reductions across procedures: ORIF (5.2%→1.0%), HA (9.2%→2.4%), and KA (4.8%→1.2%). In 2023, approximately 31 SSIs and one infection-related death were prevented, avoiding 308 hospital days. Cost savings ranged from USD 209,188 to USD 376,898, with cost saving confirmed in 93% of simulations. <b>Conclusions</b>: Comprehensive infection-prevention protocols, delivered through a structured IPC service, significantly reduced SSIs and generated substantial cost savings. These findings support wider use of these PMs in orthopedic surgery.
Authors
- Raquel Bandeira da Silva
- Bráulio Roberto Gonçalves Marinho Couto (ORCID: https://orcid.org/0000-0002-5314-5161)
- Mauro José Costa Salles (ORCID: https://orcid.org/0000-0002-5443-6024)
- Patrícia Almeida de Vasconcellos Rocha (ORCID: https://orcid.org/0000-0002-1510-1985)
- Felipe Ismael Ulloa Gómez (ORCID: https://orcid.org/0000-0003-4122-5778)
- Pedro Moreira (ORCID: https://orcid.org/0000-0002-7035-7799)
- Gabrielle Adriane Rodrigues Mota (ORCID: https://orcid.org/0000-0002-7493-7352)
- Thiago de Carvalho Gontijo (ORCID: https://orcid.org/0000-0002-4818-3948)
- Ana Carolina Morganti
- Laila Gonçalves Machado
- Gabriel Costa Colen (ORCID: https://orcid.org/0009-0003-2851-9226)
- Pedro Assis Mourão
Institutions
- Faculdade de Ciências Médicas de Minas Gerais (BR)
- Universidade Federal de São Paulo (BR)
Publication Details
- Journal
- Antibiotics
- Published
- 2025-09-05
- DOI
- https://doi.org/10.3390/antibiotics14090900
- Citations
- 2
- Primary Topic
- Orthopedic Infections and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 4.01