scholarly journals Evaluation of 3 Alcohol-based Agents for Presurgical Skin Preparation in Mice

2020 ◽  
Vol 59 (1) ◽  
pp. 67-73
Author(s):  
Monika K Huss ◽  
Kerriann M Casey ◽  
Jing Hu ◽  
Roberta C Moorhead ◽  
Helen H Chum
Keyword(s):  
Space Constraint ◽  
Surgical Procedure ◽  
Povidone Iodine ◽  
Skin Irritation ◽  
Histopathologic Examination ◽  
Bacterial Identification ◽  
Aseptic Technique ◽  
Skin Preparation ◽  
Bacterial Populations ◽  
Crucial Component

Appropriate aseptic technique is a crucial component of rodent survival surgery. Ease of technique, surgical space constraint, batch surgery, and cost are factors that may affect researcher compliance with appropriate aseptic technique. The first part of this study compared 3 antiseptic preparation agents with the standard triplicate application of povidone-iodine and alcohol. Euthanized mice (n = 40) were shaved on the dorsum, and culture swabs were taken for RODAC plating and bacterial identification. Shaved sites were prepared by using one of the 4 antiseptic preparation agents. Culture samples were obtained immediately and at 20 min after antiseptic preparation. In the 2nd part of the study, 8 mice (n = 2 per group) were prepared for a survival surgical procedure by using one of the 4 antiseptic preparation agents to evaluate whether the antiseptic preparation agents caused skin irritation or impaired healing. Results from this study indicated that all 3 of the antiseptic agents evaluated were equally effective at reducing bacterial populations immediately and at 20 min after preparation. Histopathologic examination of the incision sites revealed signs of normal healing without lesions adjacent to the incision site. We conclude that all 3 of the products evaluated are comparable to traditional povidone–iodine and alcohol as agents for aseptic preparation of surgical sites.

scholarly journals Single versus Double Skin Preparation for Infection Prevention in Proximal Humeral Fracture Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Davide Blonna ◽  
Valeria Allizond ◽  
Enrico Bellato ◽  
Giuliana Banche ◽  
Anna Maria Cuffini ◽  
...  
Keyword(s):  
Proximal Humeral Fracture ◽  
Povidone Iodine ◽  
Bacterial Load ◽  
Positive Culture ◽  
Humeral Fracture ◽  
Microbiological Analysis ◽  
Coagulase Negative Staphylococci ◽  
Skin Preparation ◽  
Double Skin ◽  
Deltopectoral Approach

Preoperative skin preparation plays a major role in preventing postoperative infections. This study aims to compare a single skin preparation (povidone iodine) with a double skin preparation (chlorhexidine gluconate followed by povidone iodine). Forty patients affected by proximal humeral fracture were included in the study. The day of surgery the two skin preparation strategies were performed in the same shoulder, divided into two areas, at the level of the deltopectoral approach. Skin swabs were collected from each area and subjected to microbiological analysis. Both skin preparations significantly reduced the positive culture rate. Coagulase-negative staphylococci (CoNS) dropped from 92.5% to 40% and to 7.5% after the single and double skin preparation (p<0.001), respectively. The positivity rate was reduced from 50% to 17.5% (p=0.002) and from 27.5% to 0% (p= 0.001) for Propionibacterium acnes and Staphylococcus aureus, respectively, with no difference between the two preparations. The double skin preparation had a more significant effect on bacterial load against CoNS compared to the single skin preparation (p<0.001 versus p= 0.015). In conclusion, both the approaches reduced S. aureus and P. acnes skin load, whereas the double skin preparation is more effective than the single one against CoNS. In light of our findings, preoperative strategies able to reduce bacterial load could potentially increase the final efficacy of perioperative traditional skin preparations.

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.

Clean/Dirty Scrub Technique: Is it Worth the Effort?

2001 ◽  
Vol 11 (12) ◽  
pp. 532-537
Author(s):  
Marilyn Williams ◽  
Elizabeth Bruen
Keyword(s):  
Literature Review ◽  
Surgical Procedure ◽  
Vital Role ◽  
Wound Infections ◽  
Aseptic Technique ◽  
Surgical Practice ◽  
Postoperative Wound ◽  
Bowel Surgery ◽  
Do So

Asepsis is a vital underlying practice for any surgical procedure and it is part of every perioperative nurse's responsibility to participate actively in incorporating the principles of aseptic technique into surgical practice. Not to do so exposes the patient to a risk that could have been avoided. The following literature review of the practice of clean and dirty technique in bowel surgery indicates that it may play a vital role in the prevention of postoperative wound infections.

Electrode Challenges in Amplitude-Integrated Electroencephalography (aEEG): Research Application of a Novel Noninvasive Measure of Brain Function in Preterm Infants

2011 ◽  
Vol 13 (3) ◽  
pp. 251-259 ◽  
Author(s):  
Shuyuann Wang Foreman ◽  
Lauren Thorngate ◽  
Robert L. Burr ◽  
Karen A. Thomas
Keyword(s):  
Intensive Care ◽  
Preterm Infants ◽  
Brain Function ◽  
Neonatal Intensive Care ◽  
Skin Irritation ◽  
Electrical Equipment ◽  
Skin Condition ◽  
Skin Impedance ◽  
Electrode Placement ◽  
Skin Preparation

Continuous real-time brain function monitoring of preterm infants offers a novel way to evaluate neurological development in neonatal intensive care. Direct measurement of brain function is difficult and complicated by vulnerabilities of the preterm infant population. This study illustrates the feasibility of using noninvasive hydrogel electrodes with amplitude-integrated electroencephalography (aEEG) as a simplified brain monitor in preterm infants. This article presents a systematic exploration of factors influencing the accuracy of aEEG measurement, especially skin preparation procedures and skin condition after electrode placement. The authors conducted aEEG recordings on 16 medically stable preterm infants at 31—36 weeks postmenstrual age in the neonatal intensive care unit between feedings and caregiving for approximately 3 hr. The authors systematically performed several strategies to improve electrode placement procedures and reduce skin impedance, including (a) examination of possible influences of environmental electrical equipment, (b) comparison of different hydrogel electrode types, (c) modification of skin preparation procedures, and (d) assessment of impacts of different skin conditions. The authors achieved improvements in the impedance value, length of uninterrupted recording, and percentage of the recording duration with measured impedance <20 kΩ (recommended acceptable limit). There was no report of skin irritation during or after the recording. The aEEG measurement at the bedside using hydrogel electrodes is noninvasive and feasible for reliable brain monitoring in preterm infants. This study demonstrated the importance of establishing systematic methods to ensure the accuracy and feasibility of physiologic measurements for nurse researchers.

Preoperative skin preparation with povidone-iodine

1964 ◽  
Vol 108 (3) ◽  
pp. 398-401 ◽  
Author(s):  
A.Stephen Close ◽  
Bruce F. Stengel ◽  
Harry H. Love ◽  
Marie L. Koch ◽  
Miles B. Smith
Keyword(s):  
Povidone Iodine ◽  
Skin Preparation

The PINS Trial: a prospective randomized clinical trial comparing a traditional versus an emollient skincare regimen for the care of pin-sites in patients with circular frames

2021 ◽  
Vol 103-B (2) ◽  
pp. 279-285
Author(s):  
David Ferguson ◽  
Paul Harwood ◽  
Victoria Allgar ◽  
Anu Roy ◽  
Patrick Foster ◽  
...  
Keyword(s):  
Skin Irritation ◽  
Site Infection ◽  
Epidermal Thickness ◽  
Related Factors ◽  
Skin Preparation ◽  
Treatment Groups ◽  
Cell Counts ◽  
Significant Difference ◽  
Pin Site

Aims Pin-site infection remains a significant problem for patients treated by external fixation. A randomized trial was undertaken to compare the weekly use of alcoholic chlorhexidine (CHX) for pin-site care with an emollient skin preparation in patients with a tibial fracture treated with a circular frame. Methods Patients were randomized to use either 0.5% CHX or Dermol (DML) 500 emollient pin-site care. A skin biopsy was taken from the tibia during surgery to measure the dermal and epidermal thickness and capillary, macrophage, and T-cell counts per high-powered field. The pH and hydration of the skin were measured preoperatively, at follow-up, and if pin-site infection occurred. Pin-site infection was defined using a validated clinical system. Results Out of 116 patients who were enrolled in the study, 23 patients (40%) in the CHX group and 26 (44%) in the DML group had at least one bad or ugly pin-site infection. This difference was not statistically significant (p = 0.71). There was no significant relationship between pH or hydration of the skin and pin-site infection. The epidermal thickness was found to be significantly greater in patients who had a pin-site infection compared with those who did not (p = 0.01). Skin irritation requiring a change of treatment occurred in four patients (7%) using CHX, and none using DML. Conclusion We found no significant difference in the incidence of pin-site infection between the CHX and DML treatment groups. Dermol appeared to offer a small but significant advantage in terms of tolerability. We did not find a significant association between patient or treatment related factors and pin-site infection. It is therefore difficult to make specific recommendations based upon these results. The use of either cleaning agent appears to be appropriate. Cite this article: Bone Joint J 2021;103-B(2):279–285.

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