Prevention of wound contamination using DuraPrep solution plus Ioban 2 drapes

Area of Science:

• Surgical Infection Prevention
• Medical Device Adhesion
• Orthopedic Surgery Outcomes

Background:

• Preoperative skin preparation aims to reduce microbial load and prevent surgical site infections.
• DuraPrep is a skin prep solution designed to enhance incise drape adhesion.
• Reduced incise drape lift may correlate with decreased wound contamination.

Purpose of the Study:

• To compare the efficacy of DuraPrep plus Ioban 2 drapes versus povidone iodine plus Ioban 2 drapes in reducing wound contamination during total joint replacement surgery.
• To evaluate differences in drape lift and cost between the two preoperative skin preparation methods.

Main Methods:

• A single-center, randomized trial involving 176 evaluable patients undergoing total joint replacement surgery.
• Patients were assigned to either DuraPrep solution with Ioban 2 drapes or povidone iodine scrub and paint with Ioban 2 drapes.
• Wound contamination, drape lift, and preparation costs were assessed.

Main Results:

• The proportion of patients with wound contamination was similar between the DuraPrep group (28.0%) and the povidone iodine group (36.4%).
• Mean drape lift was significantly lower in the DuraPrep group (1.5 cm) compared to the povidone iodine group (9.9 cm).
• The mean cost of skin preparation was substantially lower for the DuraPrep group ($93.36) versus the povidone iodine group ($248.91).

Conclusions:

• DuraPrep solution with Ioban 2 drapes is an effective alternative to povidone iodine scrub and paint with Ioban 2 for preventing wound contamination in total joint replacement.
• The observed improvements in drape lift and cost-effectiveness with DuraPrep may influence clinical practice decisions.