Search

Objective To investigate the effect of the modified method of preoperative skin cleaning on prevention of surgical site infection(SSI). Methods A total of 1450 patients undergoing spinal surgery were divided into the study group (n=747)and the control group(n=713)According to the preference of surgeons on method of preoperative skin cleaning. The routine preoperative skin preparation was conducted in the control group, and a modified method of preoperative skin cleaning (Jifro hand sanitizer and disinfectant gel)was performed after routine skin preparation in the study group. Besides, 50 patients in the study group were randomly selected for measuring Colony Forming Units (CFU) in the surgical area before and after cleaning the surgical site, and effect of using Jifro hand sanitizer and disinfectant gel CFU in the surgical site was analyzed. Results The incidence of SSI in the control group was 1. 96% and the study group was 0. 67%, which was statistically significant difference (P < 0. 05). After cleaning the surgical site of 50 randomly selected patients, the CFU after cleaning was fewer than that before cleaning(P < 0. 05). Conclusion The preoperative combination of Jifro hand sanitizer and disinfectant gel can effectively reduce the SSI rate and CFU, which is worth promoting in clinical practice.

Clinical preoperative skin preparations (PSPs) do not eradicate skin flora dwelling in the deepest dermal regions. Survivors constitute a persistent infection risk. In search of solutions, we created a porcine model intended for PSP developmental testing. This model employed microbiological techniques sensitive to the deep-dwelling microbial flora as these microorganisms are frequently overlooked when using institutionally-entrenched testing methodologies. Clinical gold-standard PSPs were assessed. Ten Yorkshire pigs were divided into two groups: prepared with either povidone iodine (PVP-I) or chlorhexidine gluconate (CHG) PSP. Bioburdens were calculated on square, 4 cm by 4 cm, full-thickness skin samples homogenized in neutralizing media. Endogenous bioburden of porcine skin (3.3 log10 CFU/cm2) was consistent with natural flora numbers in dry human skin. On-label PSP scrub kits with PVP-I (n = 39) or CHG (n = 40) failed the 2–3 log10-reduction criteria established for PSPs by the Food and Drug Administration (FDA), resulting in a 1.46 log10 and 0.58 log10 reduction, respectively. Porcine dermal microbiota mirrored that of humans, displaying abundant staphylococcal species. Likewise, histological sections showed similarity in hair follicle depths and sebaceous glands (3.2 ± 0.7 mm). These shared characteristics and the considerable fraction of bacteria which survived clinical PSPs make this model useful for developmental work.

Background: Preoperative skin preparation is associated with surgical site infection (SSI). Traditional preoperative shaving fails to reduce the risk of SSI. The efficacy of 2% chlorhexidine for preoperative skin preparation in percutaneous coronary intervention (PCI) is sketchy. The aim of this trial was to evaluate whether preoperative skin preparation performed with chlorhexidine was not inferior to a conventional hair removal method. Methods: Seventy-eight patients undergoing PCI were randomized into 2 groups of 39 patients, receiving either single sterilization with 2% chlorhexidine or hair shaving respectively between July 2016 and October 2016. The primary endpoints were wound infection rate and bacterial counts. Secondary endpoints were rate of SSI and adverse effects of 2% chlorhexidine. Results: The results showed that 2% chlorhexidine significantly reduced the colonization of Staphylococcus aureus (P = .032), S epidermidis (P = .000), and miscellaneous bacteria (P = .244) in comparison with hair shaving, respectively. Redness in 24 hours after surgery was observed in 6 patients in the control group (15.4%) and 5 patients (12.8%) in 2% chlorhexidine group. There was no statistically significant difference in SSI rate between 2 skin preparations. Conclusion: In PCI, preoperative skin preparation with 2% chlorhexidine was not inferior to conventional hair shaving in terms of the wound infection rate and SSI rate.