There are no needles or antibiotics with a host of side effects involved; just a quick pulse of light up a patient’s nose before surgery. It is quick and painless, said Dr. Elizabeth Bryce, director for infection control at the Vancouver Coastal Health Authority.
“We apply a methylene blue dye on a little swab into the front of their noses ... and shine red light — that might feel a little bit warm, but that’s about all — into their noses for two pulses of two minutes each. And then they’re good to go,” Bryce explained.
The technique, developed by a Vancouver company, is effective because most of the bacteria that cause surgical site infections come from on or within the patient’s body, Bryce explained.
“During the course of an operation, organisms migrate and they also float through the air and they land in our wounds,” she said. “So if you could decrease the amount of bacteria on somebody’s body, then you can reduce the risk of having an infection after the surgery.”
The dye contains a substance designed to latch onto the targeted bacteria and then absorb much of the energy from the laser-generated light. It is that energy that kills the bacteria.
The technique, known as photo-disinfection, reduced the number of surgical site infections to 50 from 85, when combined with the use of antibacterial body wipes, during a pilot project at the hospital over the past year. The trial of 5,000 patients, funded by the VGH and UBC Hospital Foundation, reduced average readmissions for surgical site infections to 1.25 cases a month from four and shortened hospital stays for surgical patients. This allowed doctors to perform 138 additional surgeries.
The warm, moist, dark and humid environment inside the nose is a particularly inviting place for bacteria, Bryce said. It’s also home to a strain known as staphylococcus aureus, carried by about a quarter of the population, that can cause “quite devastating” infections if it gets into surgical wounds, she added.
“If we are a staph aureus carrier, we do have a higher risk of getting a surgical site infection. So there’s the bacteria on our body and the bacteria in our nose, of which a real culprit can be staph aureus.”
It will cost about $500,000 a year to run the program at VGH, which is expected to do 7,000 surgeries next year, Bryce said. That cost will be more than offset by the savings from fewer infections, which amounted to $1.9 million during the pilot project, she added.
The photo-disinfection technology was developed by Ondine Biomedical, which specializes in developing alternatives to antibiotics. A similar procedure is already being used by some dentists.
Because the technology is easy to use and to incorporate into the pre-operative areas of hospitals, Bryce said it is something she can see being rolled out across the health region and even used to treat other kinds of infections, such as urinary tract or ventilator-associated pneumonia.
“In this day and age of increasing resistance to antibiotics, it offers (the possibility) that we might have an alternative treatment.”
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