Comparison of three skin preparation techniques. Part 2: Clinical trial in 100 dogs

The skin of 100 dogs undergoing clean or clean-contaminated surgical procedures was prepared with povidone-iodine (PI) or 4% chlorhexidine gluconate (CG) with saline or 70% isopropyl alcohol rinse. Skin bacteria at the incision site were quantified with Replication Organism Detection and Counting (RODAC) plates immediately before and after skin preparation in the preparation room, in the operating room, and postoperatively. The percentage of bacterial reduction, negative cultures, cultures with more than five colony-forming units, and skin reactions for each technique were calculated for each sample period and analyzed with the analysis of variance and Fischer tests. The percentage of bacterial reduction for all techniques was significant and comparable with results of a previous experimental study. There were no significant differences in percentages of bacterial reduction between PI and the CG techniques for surgical times up to 8 hours. There were fewer negative cultures and more cultures with high bacterial counts with PI than with CG and saline after the cleansing scrub. There were fewer negative cultures after surgery with CG and alcohol than with the other two techniques. Duration of the surgical procedure did not significantly affect the culture results. Significantly more skin reactions occurred with PI. The authors conclude that PI and 4% CG with a saline rinse are equally effective in antimicrobial efficacy under clinical conditions. However, 4% CG with a 70% isopropyl alcohol rinse may be inferior in residual antimicrobial activity.