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Related Experiment Videos

Studies on perioperative skin flora.

S W Newsom1, C Rowland

  • 1Papworth Hospital, Cambridge, UK.

The Journal of Hospital Infection
|April 1, 1988
PubMed
Summary

Chlorhexidine scrub did not reduce overall surgical wound infections but improved leg wound healing. It significantly altered skin flora for at least three days, with low risk of resistance developing.

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Area of Science:

  • Surgical Site Infection Prevention
  • Antimicrobial Efficacy
  • Skin Flora Management

Background:

  • Chlorhexidine in spirit is a standard antiseptic for surgical skin preparation.
  • Preoperative skin washing with chlorhexidine scrub is a recent recommendation.
  • Cardiothoracic surgical patients, especially those with coronary artery grafts and sternal/leg wounds, were the focus.

Purpose of the Study:

  • To evaluate the efficacy of chlorhexidine scrub compared to soap for reducing wound infections and altering skin flora in cardiothoracic surgery patients.
  • To assess the prevalence and antimicrobial resistance patterns of methicillin-resistant coagulase-negative staphylococci (MRSE) in surgical patients.

Main Methods:

  • Study 1: Randomized controlled trial (250 patients/group) comparing chlorhexidine scrub vs. soap for wound infection rates.
  • Study 2: Microbiological study (25 patients/group) assessing skin flora changes for 10 days post-operation.
  • Study 3: Clinical study (100 patients) investigating MRSE colonization and in vitro resistance to methicillin and chlorhexidine.

Main Results:

  • Chlorhexidine scrub did not decrease overall wound infection rates but led to faster healing and less inflammation in leg wounds.
  • Significant reduction in skin flora was observed with chlorhexidine scrub, persisting for at least 3 days post-operation.
  • MRSE prevalence increased from 3% pre-operation to 23% post-operation; MRSE showed high resistance to methicillin but limited cross-resistance to chlorhexidine.

Conclusions:

  • Chlorhexidine scrub demonstrates a marked and persistent effect on skin flora, suggesting potential benefits in reducing bacterial load.
  • While MRSE showed increased resistance to chlorhexidine, the emergence of major resistance is unlikely.
  • Further investigation into the use of postoperative chlorhexidine is warranted to explore its full potential in surgical settings.

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