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Related Concept Videos

Hand hygiene01:23

Hand hygiene

Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...

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Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
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Bacteria on external fixators: which prep is best?

Daniel J Stinner1, Michael J Beltran, Brendan D Masini

  • 1Department of Regenerative Medicine, United Stated Army Institute of Surgical Research, San Antonio, Texas 78234, USA. daniel.stinner@amedd.army.mil

The Journal of Trauma and Acute Care Surgery
|April 12, 2012
PubMed
Summary
This summary is machine-generated.

Surgical prep of external fixators showed no significant difference between chlorhexidine-gluconate and povidone-iodine solutions or application methods. Adjusting fixators exposed bacteria but did not increase counts, suggesting further prep may be beneficial.

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Area of Science:

  • Orthopedic surgery
  • Infection control
  • Biomedical engineering

Background:

  • Lack of established guidelines for surgical preparation of external fixators.
  • Need to evaluate effectiveness of different antiseptic solutions and application methods.

Purpose of the Study:

  • To compare the efficacy of chlorhexidine-gluconate (CHG) and povidone-iodine (PI) surgical scrubs and sprays in reducing bacterial contamination on external fixator constructs.
  • To assess bacterial distribution and counts before and after simulated external fixator adjustments.

Main Methods:

  • External fixator constructs contaminated with Staphylococcus aureus were treated with CHG (4%) or PI (10%) using either scrub or spray methods.
  • Bacterial contamination was quantified and spatially mapped using a specialized photon-capturing camera system.
  • Simulated adjustments of fixator components were performed, and constructs were reimaged to assess bacterial exposure.

Main Results:

  • No significant difference in bacterial reduction was observed between CHG and PI solutions (p=0.41) or between scrub and spray application methods (p=0.27).
  • Simulated external fixator adjustments exposed previously unseen bacteria, particularly in loosened clamps, but did not lead to a statistically significant increase in overall bacterial counts (p=0.11).

Conclusions:

  • Current surgical preparation methods and solutions (CHG, PI) demonstrate similar efficacy in reducing bacterial load on external fixators.
  • While adjustments expose bacteria, counts do not increase; however, re-prepping newly exposed surfaces after component manipulation may further minimize contamination risk.