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No need for preoperative antiseptics in elective outpatient plastic surgical operations: a prospective study
A J Kalantar-Hormozi1, Babak Davami
1Department of Plastic and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. kalantarj@yahoo.com
Abstract:
The development of antisepsis in the late nineteenth and early twentieth centuries revolutionized health care. The time-honored technique of skin preparation is to scrub the entire operative area of the patient for 5 to 7 minutes with a germicidal detergent solution and then paint the region with an antimicrobial solution of either tincture of povidone-iodine (Betadine) or chlorhexidine. Although antiseptics result in lower colony counts on the skin, they have side effects and higher cost in relation to normal saline. The authors have prepared patients by showering the surgical site with soap and water and rinsing it with normal saline, in 905 cases of outpatient, clean-wound plastic surgery. In another 905 cases that served as the control group, the traditional method of preoperative shower and scrub with chlorhexidine or Betadine was used. In both groups, there was no incidence of wound infection.
Insights
Washing surgical sites with soap, water, and normal saline is as effective as traditional antiseptic skin preparation for preventing wound infections in outpatient plastic surgery. This simpler method avoids antiseptic side effects and costs.
Area of Science:
- Medical Microbiology
- Surgical Site Infection Prevention
- Antisepsis
Background:
- Traditional skin preparation involves prolonged scrubbing with germicidal solutions like povidone-iodine or chlorhexidine.
- Antiseptics reduce skin microbial counts but can cause side effects and are costly.
- Normal saline offers a lower-cost alternative to traditional antiseptics.
Purpose of the Study:
- To evaluate the efficacy of a simplified skin preparation method using soap, water, and normal saline.
- To compare the incidence of surgical site infections between the simplified method and traditional antiseptic preparation.
- To assess the cost-effectiveness and safety of alternative skin preparation techniques.
Main Methods:
- A prospective study involving 1810 patients undergoing outpatient, clean-wound plastic surgery.
- Intervention group (905 patients): Surgical site preparation with soap, water, and normal saline rinse.
- Control group (905 patients): Traditional preoperative shower and scrub with chlorhexidine or povidone-iodine.
Main Results:
- No surgical wound infections were reported in either the intervention group or the control group.
- The simplified skin preparation method demonstrated comparable efficacy to traditional antiseptic methods.
- No adverse events or complications were specifically attributed to the simplified skin preparation method.
Conclusions:
- Washing with soap, water, and normal saline is a safe and effective alternative to traditional antiseptic skin preparation for clean-wound outpatient plastic surgery.
- This method offers potential benefits in terms of reduced cost and fewer side effects.
- Further research may explore broader applications of this simplified approach in various surgical settings.
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