Financial Analysis of Preoperative Nasal Decolonization With Povidone-Iodine in Closed Pilon Fracture Definitive Fixation

Elizabeth P. Barker, Peter P. Harimtepathip, Michael J. Steflik, Bethany L. Graulich, James A. Blair, Jana M. Davis

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The purpose of this study is to determine the financial practicality for the use of nasal povidone-iodine (NP-I) in the preoperative holding area in attempt to decrease the rate of infection that is associated with operative fixation of closed pilon fractures. Institutional costs for treating postoperative infection following a closed pilon fracture, along with costs associated with preoperative NP-I use, were obtained. A break-even equation was used to analyze these costs to determine if the use of NP-I would decrease the current infection rate (17%) enough to be financially beneficial for routine use preoperatively. The total cost of treating a postoperative infection was found to be $18,912, with the cost of NP-I being $30 per patient dose. Considering a 17% infection rate and utilizing the break-even equation, NP-I was found to be economically viable if it decreased the current infection rate by 0.0016% (Number Needed to Treat = 63,051.7). This break-even model suggests that the use of NP-I in the preoperative holding area is financially beneficial for decreasing the rate of infection associated with the treatment of closed pilon fractures.

Original languageEnglish (US)
Pages (from-to)119-122
Number of pages4
JournalJournal of Foot and Ankle Surgery
Issue number1
StatePublished - Jan 1 2024

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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