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Comparison of preoperative skin preparations for the face
L M Dzubow1, A C Halpern, J J Leyden
1Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Abstract:
Antiseptic preparation of the skin before dermatologic surgical procedures should provide maximal reduction of cutaneous microflora for the duration of the operation. No data currently exist concerning the efficacy of topical antimicrobials on the most common site of cutaneous surgery, the face. In this study the potency and temporal characteristics of three antimicrobials were tested on the faces of 14 volunteers. A 10-second wipe of 70% isopropyl alcohol was as effective in reducing aerobic microflora at the 5-minute postoperative period as a 60-second alcohol wipe or a 60-second povidone-iodine or chlorhexidine tincture application. At 60 minutes after the application, aerobic bacterial reduction possibly was better maintained by the povidone than by the 10- or 60-second alcohol preparation. None of the antiseptics tested were capable of a profound reduction of the anaerobic flora present on the sebaceous facial regions.
Insights
A quick alcohol wipe effectively reduces facial bacteria after surgery, similar to longer applications. Povidone-iodine may offer better sustained bacterial reduction compared to alcohol.
Area of Science:
- Dermatology
- Infectious Disease
- Surgical Preparation
Background:
- Effective skin antiseptic preparation is crucial for reducing cutaneous microflora during dermatologic surgery.
- Limited data exist on topical antimicrobial efficacy specifically for facial cutaneous surgery, a common surgical site.
Purpose of the Study:
- To evaluate the potency and temporal efficacy of three topical antiseptics on facial skin microflora.
- To compare short-duration alcohol wipes with longer antiseptic applications for surgical site preparation.
Main Methods:
- Fourteen volunteers underwent facial skin preparation using 70% isopropyl alcohol (10- and 60-second wipes), povidone-iodine, and chlorhexidine tincture.
- Aerobic and anaerobic microflora were quantified at 5 and 60 minutes post-application.
- Comparison of bacterial reduction across different antiseptic agents and application times.
Main Results:
- A 10-second 70% isopropyl alcohol wipe demonstrated comparable aerobic microflora reduction at 5 minutes to a 60-second alcohol wipe, povidone-iodine, or chlorhexidine.
- Povidone-iodine showed potentially superior sustained aerobic bacterial reduction at 60 minutes compared to both 10- and 60-second alcohol preparations.
- No tested antiseptic achieved significant reduction of anaerobic flora on sebaceous facial regions.
Conclusions:
- Short-duration alcohol skin preparation can be effective for immediate postoperative bacterial reduction on the face.
- Povidone-iodine may offer more prolonged aerobic bacterial control than alcohol for facial surgical sites.
- Current antiseptics are insufficient for complete eradication of anaerobic facial microflora.