Michael E. DeBakey VA Medical Center - Houston, Texas

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Using Air to Blast Away Infection

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Dr. Darouiche

“One goal of this clinical trial is to determine the effectiveness of this new technology at reducing bacterial contamination of surgical incisions,” said Rabih O. Darouiche, M.D., VA Distinguished Service Professor in the departments of Physical Medicine and Rehabilitation, Medicine, and Surgery and the study’s principal investigator. PHOTO: Quentin Melson, Public Affairs Specialist (TCF Intern)

Monday, December 5, 2011

HOUSTON – As a result of a $1.2 million award from the National Institutes of Health, the Michael E. DeBakey VA Medical Center (MEDVAMC) is initiating a pilot study of a novel device to determine its ability to reduce bacterial contamination and decrease the incidence of surgical site infection after surgical procedures requiring insertion of prostheses. 

“This randomized, controlled clinical trial will investigate the incidence of surgical site infection occurring after hip arthroplasty, vertebral fusion, and femoral-popliteal grafting procedures performed over a two-year period,” said Rabih O. Darouiche, M.D., VA Distinguished Service Professor in the departments of Physical Medicine and Rehabilitation, Medicine, and Surgery and the study’s principal investigator.

Surgical site infections are a serious postoperative complication affecting almost 500,000 patients annually. In particular, infections occurring after surgical implementations of prostheses cause severe illness and the cost of treatment can reach $100,000 per incidence.

Most infections occurring after surgical implantation of prostheses are caused by microorganisms that become attached to the implants at the time of surgery. Research published in peer-reviewed journals indicate that a common source of these bacteria are skin cells shed by operating room personnel into the airborne environment that settle onto the surgical field.

“The Air Barrier System is intended to shield surgical sites from airborne contaminants in the operating room by creating a localized ‘cocoon’ of ultraclean air surrounding incisions. This prevents the intrusion of airborne contaminants by sweeping them away,” said Darouiche, who is also the founder and director of the Center for Prostheses Infection at Baylor College of Medicine. “The ABS is currently approved by the Food and Drug Administration for use in hip surgery and does not interfere with the procedure.” 

During a Phase I Clinical Study published in the Journal of Arthroplasty, the ABS reduced the presence of bacteria at incision sites during hip arthroplasty by 84 percent as compared to the ambient air present in surgical theatres.

The goals of this clinical trial are to determine the effectiveness of the ABS at reducing bacterial contamination of surgical incisions and detect trends in the rates of surgical site infection between the experimental group that uses the ABS versus the control group that does not.

Veterans undergoing orthopedic, neurosurgical or vascular surgical procedures that entail implantation of prostheses will be eligible for study enrollment. 

“Should the study yield promising results, the research conducted at Michael E. DeBakey VA Medical Center could lead to a breakthrough in addressing infection prevention in the operating room environment,” said Darouiche.

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Awarded re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 130,000 veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, and treatment of spinal cord injury and diseases. The MEDVAMC is home to a Post Traumatic Stress Disorder Clinic; Network Polytrauma Center; an award-winning Cardiac and General Surgery Program; Liver Transplant Center; VA Epilepsy and Cancer Centers of Excellence; VA Substance Abuse Disorder Quality Enhancement Research Initiative; Health Services Research & Development Center of Excellence; VA Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; Mental Illness Research, Education and Clinical Center; and one of the VA’s six Parkinson’s Disease Research, Education, and Clinical Centers. Including the outpatient clinics in Beaumont, Conroe, Galveston, Houston, Lufkin, Richmond, and Texas City, MEDVAMC outpatient clinics logged almost 1.3 million outpatient visits in fiscal year 2011. For the latest news releases and information about the MEDVAMC, visit www.houston.va.gov.