Ring fencing of hospital wards and simple infection control measures can eradicate MRSA in patients having planned operations and allow more patients to be treated, show researchers in this week's BMJ.
Their study involved all patients undergoing elective hip or knee replacement at Broomfield Hospital in Essex. In April 1998, all orthopaedic surgery was centralised to this hospital from a dedicated stand-alone orthopaedic hospital. Twenty-nine new cases of MRSA occurred in the first year after the move.
For one year, rates of postoperative infections were recorded. Then in July 2000, the 28 beds in the elective orthopaedic ward were "ring fenced." Only patients having elective orthopaedic surgery were admitted to the ward and infection control measures were rigorously enforced.
These measures led to a significant decrease in all postoperative infections and also allowed 17% more patients to be treated without increasing the number of operating lists, beds, or surgeons. No cases of MRSA occurred after ring fencing.
"We strongly recommend the ring fencing of elective orthopaedic patients and simple infection control measures to reduce the risk of postoperative infection and allow an increase in the number of patients treated," conclude the authors.