scholarly journals Comparison between Uses of Chlorhexidine Gluconate versus Povidone Iodine for Skin Preparation to Prevent Infection after Cardiothoracic Surgery

2017 ◽  
Vol 06 (02) ◽  
pp. 72-80
Author(s):  
Nesma Shaker Said
2017 ◽  
Vol 19 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Shahzad G Raja ◽  
Melissa Rochon ◽  
Clair Mullins ◽  
Carlos Morais ◽  
Antonios Kourliouros ◽  
...  

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.


Animals ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 120
Author(s):  
Erin B. Perry ◽  
Dakota R. Discepolo ◽  
Stephen Y. Liang ◽  
Eileen K. Jenkins

Evidence-based canine decontamination protocols are underrepresented in the veterinary literature. Aerosolized microbiological and chemical contaminants can pose a risk in deployment environments highlighting the need for improved canine field decontamination strategies. Prior work has established the efficacy of traditional, water-intensive methods on contaminant removal from the coat of the working canine; however, it is not known if similar reductions can be achieved with simple field expedient methods when resources are limited. The objective of this study was to measure the reduction of aerosolized contamination via a practical “wipe-down” procedure performed on working canine coats contaminated with a fluorescent, non-toxic, water-based aerosol. Disposable, lint-free towels were saturated with one of three treatments: water, 2% chlorhexidine gluconate scrub (CHX), or 7.5% povidone-iodine scrub (PVD). Both CHX and PVD were diluted at a 1:4 ratio. Treatments were randomly assigned to one of three quadrants established across the shoulders and back of commonly utilized working dog breeds (Labrador retrievers, n = 16; German shepherds, n = 16). The fourth quadrant remained unwiped, thus serving as a control. Reduction in fluorescent marker contamination was measured and compared across all quadrants. PVD demonstrated greater marker reduction compared to CHX or water in both breeds (p < 0.0001). Reduction was similar between CHX or water in Labradors (p = 0.86) and shepherds (p = 0.06). Effective wipe-down strategies using common veterinary cleansers should be further investigated and incorporated into decontamination practices to safeguard working canine health and prevent cross-contamination of human personnel working with these animals.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Davide Blonna ◽  
Valeria Allizond ◽  
Enrico Bellato ◽  
Giuliana Banche ◽  
Anna Maria Cuffini ◽  
...  

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.


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