scholarly journals Comparison of the Efficacy of Chlorhexidine Gluconate versus Povidone Iodine as Preoperative Skin Preparation for the Prevention of Surgical Site Infections

2017 ◽  
Vol 05 (04) ◽  
Author(s):  
Dr Mohd. Rafik Rao
Keyword(s):  
Povidone Iodine ◽  
Surgical Site Infections ◽  
Chlorhexidine Gluconate ◽  
Skin Preparation

scholarly journals Povidone-iodine-alcohol is superior to chlorhexidine-alcohol in its antimicrobial efficacy on the anaerobic microbial flora in surgical skin preparation of the shoulder region

2019 ◽  
Author(s):  
Dorothea Dörfel ◽  
Georg Daeschlein ◽  
Matthias Maiwald ◽  
Gerald Müller ◽  
Robert Hudek ◽  
...  
Keyword(s):  
Povidone Iodine ◽  
Surgical Site Infections ◽  
Shoulder Surgery ◽  
Skin Microbiome ◽  
Negative Effects ◽  
Skin Preparation ◽  
Prolonged Contact ◽  
Skin Flora ◽  
Cutibacterium Acnes ◽  
Skin Antisepsis

Abstract Background: Cutibacterium acnes is part of the anaerobic skin microbiome and resides in deeper skin layers. The organism is an important agent of surgical site infections (SSI), particularly in shoulder surgery, and is difficult to target with skin antisepsis. We hypothesized that prolonged preparation with an agent that penetrates deeper into the skin is more effective in shoulder surgery. Thus, we compared two different classes of antiseptics, each combined with alcohol, and each applied with two different contact times. Methods: Shoulders of 16 healthy volunteers were treated for 2.5 min (standard) or 30 min (prolonged) with alcohol-based chlorhexidine (CHG-ALC; 2% w/v CHG, 55% w/v [70% v/v] 2-propanol) or alcohol-based povidone iodine (PVP-I-ALC; 3.24% w/v PVP-I, 38.9% w/v 2-propanol, 37.3% w/v ethanol). Skin sites were sampled before, immediately after, and 3 h after treatment. Results: Aerobic skin flora was reduced more effectively by PVP-I-ALC than by CHG-ALC after 2.5 min and immediate sampling, but not after prolonged contact times and 3-h sampling. Anaerobic flora was reduced more effectively by PVP-I-ALC than by CHG-ALC after standard and prolonged contact times and immediate sampling, but not after 3-h sampling. None of the volunteers reported negative effects from skin antisepsis. Conclusions: PVP-I-ALC is more efficacious than CHG-ALC for topical skin antisepsis regarding the anaerobic flora on the skin of the shoulder. Standard and prolonged contact times demonstrated superiority for PVP-I-ALC for samples taken immediately, but missed significance 3 h after application. The clinical relevance of these findings should be studied with SSI as an endpoint.

scholarly journals Impact of choice of skin preparation solution in cardiac surgery on rate of surgical site infection: a propensity score matched analysis

2017 ◽  
Vol 19 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Shahzad G Raja ◽  
Melissa Rochon ◽  
Clair Mullins ◽  
Carlos Morais ◽  
Antonios Kourliouros ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Relative Risk ◽  
Propensity Score ◽  
Confidence Interval ◽  
Surgical Site Infection ◽  
Povidone Iodine ◽  
Chlorhexidine Gluconate ◽  
Site Infection ◽  
Skin Preparation ◽  
Significant Superiority

Background: Antiseptic skin preparations containing chlorhexidine gluconate and povidone iodine are routinely used to reduce the risk of surgical site infection (SSI). This study assesses the efficacy of two alcohol-based solutions, 2% chlorhexidine-alcohol and 10% povidone iodine-alcohol, on the incidence of cardiac SSI. Methods: A total of 738 consecutive patients undergoing cardiac surgery had skin preparation with 2% chlorhexidine gluconate in 70% isopropanol (ChloraPrep, BD Ltd, UK) were propensity matched to 738 patients with skin prepared with 10% povidone–iodine in 30% industrial methylated spirit (Videne Alcoholic Tincture, Ecolab Ltd, UK). Continuous, prospective SSI surveillance data were collected for all these patients. A retrospective analysis of prospectively collected perioperative data was performed. Results: The overall rate of SSI was similar in the chlorhexidine–alcohol and povidone–iodine–alcohol groups (3.3% versus 3.8%; P = 0.14; relative risk [RR] = 0.98; 95% confidence interval [CI] = 0.52–1.78). Superficial (1.2% versus 1.8%; P = 0.18; RR = 0.97; 95% CI = 0.48–1.80) and deep incisional (1.2% versus 1.6%; P = 0.24) SSI rates were also similar with 10% povidone–iodine–alcohol being marginally more effective against organ-space infections (0.8% versus 0.4%; P = 0.05; RR = 0.38; 95% CI = 0.20–1.01). Conclusion: Our analysis confirms that alcohol-based skin preparation in cardiac surgery with povidone–iodine reduces the incidence of organ-space infections with no significant superiority in preventing incisional SSI compared with chlorhexidine-alcohol.

scholarly journals Effect of 4% Chlorhexidine Gluconate Predisinfection Skin Scrub Prior to Hepatectomy: A Double-Blinded, Randomized Control Study

2014 ◽  
Vol 99 (6) ◽  
pp. 787-794 ◽  
Author(s):  
Ching-Shui Hsieh ◽  
Hsiu-Chi Cheng ◽  
Jen-Shiou Lin ◽  
Shou-Jen Kuo ◽  
Yao-Li Chen
Keyword(s):  
Surgical Site Infections ◽  
Chlorhexidine Gluconate ◽  
Microbial Colonization ◽  
Hepatic Tumors ◽  
Skin Preparation ◽  
Randomized Control ◽  
Transplantation Center ◽  
Skin Decontamination ◽  
Double Blinded ◽  
Control Study

Abstract This trial was designed to compare the efficacy of 4% chlorhexidine gluconate (CHG) with normal saline (NS) as a predisinfection skin-scrub solution prior to standard presurgical skin preparation. Data was collected at a single transplantation center where patients electing resection of hepatic tumors were recruited between October 2011 and September 2012. In total, 100 patients were consecutively enrolled for random assignment to either 4% CHG or NS as a predisinfection skin-scrub solution prior to surgery. Our aim was to assess the comparative antiseptic efficacy of CHG in this setting, focusing on cutaneous microbial colonization (at baseline, preoperatively, and postoperatively) and postsurgical site infections as primary outcome measures. Positivity rates of baseline, preoperative, and postoperative cultures were similar for both groups, showing significant declines (relative to baseline) after skin preparation and no significant postsurgical rebound. Rates of surgical site infection were also similar in both groups (CHG, 6.0%; NS, 4.1%; P = 1.0). For patients with hepatic tumors undergoing hepatectomy, the effect of 4% CHG as a predisinfection scrub solution was similar to that of NS in terms of skin decontamination and surgical site infections.

scholarly journals Chlorhexidine Gluconate Application as A Strategy to Reduce Cardiac Implantable Electronic Device Surgical Site Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s166-s167
Author(s):  
Sreelatha Ponnaluri-Wears ◽  
Nicole Nomides ◽  
Ricci Brown ◽  
Emily Stoneman
Keyword(s):  
Electronic Device ◽  
Work Group ◽  
Surgical Site Infections ◽  
Chlorhexidine Gluconate ◽  
Skin Preparation ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Procedures ◽  
Time Period ◽  
Routine Surveillance ◽  
Before And After

Background: The electrophysiology laboratory within the cardiac procedures unit (CPU) at Michigan Medicine specializes in implanting, exchanging, and extracting cardiac implantable electronic devices (CIED). During routine surveillance of surgical site infections (SSI), an increase in CIED infections (specifically endocarditis) was noted starting in 2016. The predominant organisms involved with infection were skin organisms such as Staphylococcus aureus and coagulase-negative Staphylococcus. Methods: Cases of SSI following CIED implantation were identified using positive microbiology results collected within 90 days of a procedure. Cases were classified using the NHSN SSI definitions. Upon identifying an increase in infections, a work group of key stakeholders was formed to determine root causes. Factors discussed included standardized surgical skin preparation techniques, patient education regarding bathing before and after procedures, types of surgical drapes in use, traffic in and out of procedure rooms during cases, environmental cleanliness of the procedure area, and adherence to the institutional surgical attire policy. In addition to the workgroup, several cases were observed by the IP team. Results: The investigation revealed several areas for improvement. As a first step, a practice of using 2% chlorhexidine gluconate (CHG)–impregnated bathing clothes on patients prior to surgery was implemented for the chest, neck, axilla, and arm. No other changes were implemented during this time period. In the year following implementation, there were zero cases of endocarditis and only 2 superficial SSIs (Figs. 1 and 2). Conclusions: Employing application of CHG to reduce the microbial burden on the skin significantly aided in preventing infections related to CIEDs.Funding: NoneDisclosures: None

scholarly journals Meta-analysis of the efficacy of preoperative skin preparation with alcoholic chlorhexidine compared to povidone iodine in orthopedic surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mario Mastrocola ◽  
Georg Matziolis ◽  
Sabrina Böhle ◽  
Chris Lindemann ◽  
Peter Schlattmann ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Povidone Iodine ◽  
Meta Analysis ◽  
Bacterial Flora ◽  
Positive Culture ◽  
Surgical Site Infections ◽  
Skin Preparation ◽  
Skin Flora ◽  
Skin Colonization ◽  
Normal Bacterial Flora

AbstractPreoperative skin preparation is an effective method to prevent surgical site infections (SSI). Alcoholic chlorhexidine (CHG) and povidone iodine (PV-I) are the most widely used antiseptic agents. This meta-analysis aims to determine their efficacy in reducing natural bacterial skin flora in clean orthopedic surgery. A systematic search was conducted through current literature up to June 2021 to identify clinical randomized trials that compared the efficacy of alcoholic chlorhexidine and povidone iodine in reducing bacterial skin colonization after preoperative skin preparation. A meta-analysis was conducted. Of 235 screened articles, 8 randomized controlled trials were included. The results of the meta-analysis demonstrate a significantly lower positive culture rate in the chlorhexidine group than in the povidone iodine group (RR = 0.53, 95% Cl: 0.32–0.88). The present data show the superiority of chlorhexidine in reducing the normal bacterial flora compared to povidone iodine in clean orthopedic surgery.

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