The caloric deficit required for a pound of body weight loss is reported to be 3,500 kilocalories (Wishnofsky, 1960). However, published articles, textbooks, and professional organizations equate a pound of fat mass loss to 3,500 kilocalories
1 the conclusion was made "that two-phase antisepsis using isopropanol followed by CH is a more effective preparation for blood culture in neonates t h a n is CH a l o n e . " However, they failed to include a control using isopropanol alone although acknowledging that isopropanol is an "excellent antiseptic in its own right." It may be possible that the results ascribed to the two-phase procedure are actually due to the isopropanol alone. Inclusion of this control could have answered this question and possibly indicate that a one-step procedure with the isopropanol would be equivalent to the results presented. The authors of the article were invited to respond.Our principal objective was to compare the skin antisepsis regimen used in our nursery (Hibitane tincture) with recommended regimens (Isopropanol followed by Hibitane tincture or Povidone-iodine solution).
1Our observations showed the recommended two-phase regimens to be superior. Because the Hibitane preparation c o n t a i n s 70% e t h a n o l , we thought it unlikely that Isopropanol used alone would prove satisfactory. Indeed, in eight infants whose forearm skin was colonized with Staphylococcus epidermidis, we found that a 60-second application of Isopropanol 70% de-germed the skin surface of only three. In the remaining five patients, the density of surface bacteria was reduced by this treatment but continued to exceed 10 2 organisms per cm 2 . This result was so like that obtained with Hibitane tincture that we rejected alcohol antisepsis alone as an effective m e a n s of p r e p a r i n g infants' skin for blood culture. We are not aware of any authoritative body which has sanctioned alcohol antisepsis for this purpose although we do not deny its usefulness in other circumstances.
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