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.

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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
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article

Comparison of Cost Savings of Methods of Prevention of Orthopedic Implant-Associated Infection in Arthroplasty and Closed Fracture Surgery Patients

Raquel Bandeira da Silva, Bráulio Roberto Gonçalves Marinho Couto, Mauro José Costa Salles, Patrícia Almeida de Vasconcellos Rocha et al.
2 citations
Antibiotics
Orthopedic Infections and Treatments
4.01
article

Comparison of Cost Savings of Methods of Prevention of Orthopedic Implant-Associated Infection in Arthroplasty and Closed Fracture Surgery Patients

Raquel Bandeira da Silva, Bráulio Roberto Gonçalves Marinho Couto, Mauro José Costa Salles, Patrícia Almeida de Vasconcellos Rocha, Felipe Ismael Ulloa Gómez, Pedro Moreira, Gabrielle Adriane Rodrigues Mota, Thiago de Carvalho Gontijo, Ana Carolina Morganti, Laila Gonçalves Machado, Gabriel Costa Colen, Pedro Assis Mourão
article en
2 citations

Abstract

<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.

AntibioticsVol. 14(9)
Faculdade de Ciências Médicas de Minas Gerais (BR), Universidade Federal de São Paulo (BR)
Openalex Percentile: Top 6%
Orthopedic Infections and Treatments
4.01
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