Steriwave® a non-antibiotic nasal photodisinfection strategy reduces infection burden in endoscopic skull base surgery.

BACKGROUND

Surgical site infection is a major cause of morbidity. Standard pre-operative nasal decolonisation depends on patient-led, multiday topical antibiotics, which suffer from poor adherence and contribute to antimicrobial resistance. Clinician-delivered nasal photodisinfection offers an immediate, non-antibiotic alternative.

METHODS

A single-centre before-and-after service evaluation compared surgical site infection outcomes before and after implementation of a pre-operative nasal photodisinfection protocol in adults undergoing endoscopic anterior skull base surgery. The primary outcome was 30-day surgical site infection; secondary outcomes were post-operative meningitis and excess bed-stay.

RESULTS

Two hundred patients were included (105 standard; 95 photodisinfection). Surgical site infection occurred in 15 patients (14.6 per cent) with standard care versus 3 (3.2 per cent) after photodisinfection, an absolute risk reduction of 11.4 per cent (95 per cent CI 3.7-19.1; p = 0.0059). Meningitis occurred in five standard-care patients and none after photodisinfection. Compliance was 100 per cent, with no adverse events.

CONCLUSION

Photodisinfection was associated with substantially reduced surgical site infection.