Antisepsis Techniques in Orthopedic Surgical Procedures: A Comparative Study

Area of Science:

• Infectious Disease
• Surgical Site Infection Prevention
• Antimicrobial Stewardship

Background:

• Surgical site infections (SSIs) are a significant concern in orthopedic procedures.
• Effective skin antisepsis is crucial for preventing SSIs.
• Evaluating different antiseptic protocols is essential for optimizing patient safety.

Purpose of the Study:

• To compare the efficacy of two skin antisepsis techniques in orthopedic surgery.
• To evaluate chlorhexidine-based soap combined with ethyl alcohol versus alcohol-based chlorhexidine alone.
• To assess bacterial growth following different antiseptic protocols.

Main Methods:

• A single-center, randomized clinical trial involving 170 orthopedic surgery patients.
• Two groups were assigned: chlorhexidine-based soap + alcohol-based chlorhexidine (CSAC) and chlorhexidine-based soap + 70% ethyl alcohol + alcohol-based chlorhexidine (CSAAC).
• Bacterial cultures (mannitol and EMB) were collected at three time points: before preparation, after preparation, and post-surgery.

Main Results:

• No statistically significant difference in bacterial growth was observed between the CSAC and CSAAC groups at any time point.
• The type of bacterial growth in culture media also showed no statistical difference between the groups and time points.
• Both antiseptic techniques demonstrated comparable effectiveness in reducing bacterial load.

Conclusions:

• Neither antisepsis technique showed superiority in preventing bacterial growth for orthopedic surgical site infections.
• The study supports the use of either protocol, highlighting the importance of consistent application.
• A protocol for infection prevention in orthopedic procedures was developed based on these findings.