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The antimicrobial effectiveness of operative-site preparative agents: a microbiological and clinical study
Abstract:
Eight wound preparative agents (one triclosan compound, one hexachlorophene compound, and six iodophors) were evaluated under actual operating-room conditions for efficacy in de-germing the operative site prior to the performance of 310 total hip arthroplasties. All of the preparations tested achieved a significant reduction (p less than or equal to 0.001) of indigenous skin microflora compared with the pre-scrub level in both the post-scrub and the postoperative cultures. Two iodophors, when applied as sprays, demonstrated excellent bactericidal action, were less time-consuming and easier to use than the compounds that were applied as scrubs, and did not alter the low (0.42 per cent) infection rate that we have recorded over a period of four years.
Insights
This study compared eight skin preparation agents for surgery. Two iodophor sprays effectively reduced bacteria and maintained low infection rates in total hip arthroplasties.
Area of Science:
- Surgical Site Infection Prevention
- Antimicrobial Efficacy
- Operating Room Protocols
Background:
- Effective skin preparation is crucial for preventing surgical site infections (SSIs).
- Various antimicrobial agents are used to reduce microbial load on the skin before surgery.
- Evaluating the real-world efficacy of these agents in an operating room setting is essential.
Purpose of the Study:
- To compare the efficacy of eight different wound preparative agents in reducing skin microflora.
- To assess the impact of these agents on infection rates during total hip arthroplasties.
- To evaluate the usability and time efficiency of spray-applied versus scrub-applied agents.
Main Methods:
- Eight wound preparative agents (triclosan, hexachlorophene, six iodophors) were tested.
- Efficacy was evaluated under actual operating-room conditions during 310 total hip arthroplasties.
- Microflora reduction was assessed by comparing pre-scrub, post-scrub, and postoperative cultures.
Main Results:
- All tested agents significantly reduced indigenous skin microflora (p <= 0.001).
- Two iodophor sprays showed excellent bactericidal action.
- Spray iodophors were quicker and easier to use than scrub agents.
- Spray iodophors did not negatively impact the established low infection rate (0.42%).
Conclusions:
- Iodophor sprays are effective and efficient agents for surgical skin preparation.
- These agents can help maintain low infection rates in orthopedic surgery.
- The study supports the use of spray-applied iodophors for de-germing operative sites.