Povidone-Iodine for Nasal Decolonization

This will be a prospective single-blinded randomized placebo-controlled trial of two applications of a nasal 10% Povidone Iodine (PI) solution used on the intranasal mucosal surfaces of each nostril in the preoperative holding area within 2 h prior to surgical incision compared with NS using the same technique. Both the PI and NS will be applied by rotating the swab over the intranasal mucosal surface for 15 seconds; this process will be performed twice for both nostrils, using a new swab for each application. Nasal cultures will be obtained prior to PI or NS application as well as intraoperatively 1 hour and 2 hours after first surgical incision. The primary study end point is the decrease in S. aureus/MRSA colony forming units (CFU) in nasal cultures taken within 2 hours after intervention in patients who presented with a positive preintervention nasal culture. A secondary endpoint is the presence or absence of surgical site infections within 30 days postoperatively

Inclusion criteria

• community-based patients ages 18-80
• American Society of Anesthesiology (ASA) 1-3
• undergoing an outpatient surgery for at least 1 hour and up to 6 hours duration

Exclusion criteria

• pregnancy
• allergy to povidone-iodine
• infectious indication for surgery or preexisting known infection/wound
• immunocompromised state
• use of chemotherapy or steroids within 30 days prior to surgery
• use of antimicrobial therapy within 30 days prior to surgery
• surgeries where field avoidance prevents intraoperative access to the nares