An Overview of Skin Antiseptics Used in Orthopaedic Surgery Procedures

Abstract

Surgical site infections (SSIs) in orthopaedics are a common complication, with more than half a million SSIs occurring in the United States each year. SSIs can carry a notable burden for patients and physicians alike. Skin antiseptic solution plays an important role in preventing SSI. Many studies have looked at different skin antiseptic solution in preventing SSIs. Different surgical preps can decrease bacterial loads at surgical sites in varying degrees. Yet, the amount of bacterial load does not always correlate with a lower risk of infection.Chlorhexidine, for example, has been shown to cause markedly less SSIs compared with povidone-iodine prep in general surgery cases. Whereas chlorhexidine with alcohol may best work in the forefoot, iodine povacrylex with alcohol is equivalent in the spine. Conversely, joint arthroplasty SSIs were markedly decreased with a combination of preps. Because of all these differences, understanding which prep solution to use and when can be invaluable to the orthopaedic surgeons.

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

“…The purpose of pre-incisional skin preparation is to reduce radically (within several minutes after application) the number of bacteria at the site of the operating field prior to incision and control for recolonization during surgery [105]. A wide spectrum of paint solutions, including both alcohol-and non-alcohol-based agents, have been certified for this purpose [106], but evidence for a particular product is limited. A recent systematic review and meta-analysis found superior benefit for chlorhexidine compared to povidone-iodine in clean surgery in terms of prevention of postoperative SSIs (risk ratio 0.81; 95% CI, 0.67-0.98) [107].…”

The combined utilization of Chlorhexidine and Voriconazole or Natamycin to combat Fusarium infections

“…CHL, which is a common, inexpensive, safe, and efficacious antiseptic agent exhibited promising performance. CHL is functions by binding to cell membranes and thereby impairing bacterial adhesion and driving the leakage of bacterial cellular contents [8]. Most bacterial and Candida species have been shown to be killed by 1-2% CHL solutions [9], while CHL concentrations of 1% or lower have been shown to be safe when used for ophthalmic purposes [10].…”

Physico-Chemical Properties of Antiseptics in Surgery: What is not Taken into Account in Treating Long-Term Non-Healing Wounds

“…The number of patients with purulent and long-term nonhealing wounds and the effectiveness of their treatment with the use of existing medical standards and medicines remain the same [1,2]. Therefore, the issue of developing new medicines and innovative methods of treating purulent diseases remains very relevant [3].…”

“…Гуревич 2 , А.Л. Ураков 3,* 1 Фармацевтический институт Крави, Индия, Хайдарабад 2 Московский государственный медико-стоматологический университет имени А.И. Евдокимова, Россия, Москва 3 Ижевская государственная медицинская академия, Россия, Удмуртская Республика, Ижевск * Контакты: Ураков Александр Ливиевич, e-mail: urakoval@live.ru…”