Chlorhexidine With Isopropyl Alcohol Versus Iodine Povacrylex With Isopropyl Alcohol and Alcohol- Versus Nonalcohol-Based Skin Preparations

Kaoutzanis, Christodoulos; Kavanagh, Crystal M.; Leichtle, Stefan W.; Welch, Kathleen B.; Talsma, AkkeNeel; Vandewarker, James F.; Lampman, Richard M.; Cleary, Robert K.

doi:10.1097/dcr.0000000000000379

Cited by 12 publications

(7 citation statements)

References 12 publications

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“…Some evidence suggests that chlorhexidine-based preparations are more effective, 16,17 other reviews are less conclusive. 18,19 The new protocol harnesses both mechanisms through their combined use. Chlorhexidine is used for the initial skin preparation.…”

Section: Discussionmentioning

confidence: 99%

Reducing Surgical Site Infection in Pediatric Scoliosis Surgery: A Multidisciplinary Improvement Program and Prospective 4-Year Audit

Tipper

Chiwera

Lucas

2019

Global Spine Journal

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Study Design: Single-center prospective cohort. Objectives: To evaluate a multidisciplinary led, structured protocol for reducing surgical site infections (SSIs) in pediatric scoliosis surgery. Methods: Following a spike to 8.6% in local annual infection rate, a multidisciplinary team was convened to identify interventions. The team consisted of spinal surgeons, infectious diseases consultants, physiotherapists, specialist nurses, and theatre managers. A protocol was initiated, including preoperative skin decontamination; standardized operative site prepreparation; betadine-soaked swabs sutured to wound edges; blood loss minimization; 3 L0.9% saline pulsed-lavage; defined protocol of glove changes; antibiotic regime of preoperative gentamicin, intraoperative subfascial vancomycin powder, 48-hour cefuroxime; and intraoperative normothermia. A 4-year audit was initiated of all patients aged ≤18 years undergoing corrective spinal deformity surgery. Institutional board review was not required. Results: Between January 1, 2014 and January 1, 2018, 414 operations were performed on 355 patients: male:female = 1:2.2, mean age 13.7 years (range 2.5-17.9), 233 idiopathic (mean operated vertebral levels 12), 122 neuromuscular (mean operated vertebral levels 14), 66 growing rod procedures, 41 multistage procedures. The mean number of operated vertebral levels both overall and in infected cases was 13 (range 2-17). Nine SSIs occurred in 8 patients at 3 months (4 neuromuscular), resulting in an overall SSI per operation of 2.2%. Conclusion: A multidisciplinary approach with standardized measures significantly reduced SSIs in the unit’s pediatric scoliosis surgery.

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Section: Discussionmentioning

confidence: 99%

Reducing Surgical Site Infection in Pediatric Scoliosis Surgery: A Multidisciplinary Improvement Program and Prospective 4-Year Audit

Tipper

Chiwera

Lucas

2019

Global Spine Journal

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“…More recent studies showed no significant difference between the tested antiseptics. It is difficult to compare these studies because variable antiseptics and concentrations were used.…”

Section: Preoperative Measuresmentioning

confidence: 99%

Alternatives to antibiotics for prevention of surgical infection

Ploegmakers

Damink

Breukink

2017

British Journal of Surgery

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Background: Surgical-site infection (SSI) is still the second most common healthcare-associated infection, after respiratory tract infection. SSIs are associated with higher morbidity and mortality rates, and result in enormous healthcare costs. In the past decade, several guidelines have been developed that aim to reduce the incidence of SSI. Unfortunately, there is no consensus amongst the guidelines, and some are already outdated. This review discusses the recent literature regarding alternatives to antibiotics for prevention of SSI.Methods: A literature search of PubMed/MEDLINE was performed to retrieve data on the prevention of SSI. The focus was on literature published in the past decade.

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“…A retrospective propensity-adjusted comparison of colorectal surgery performed in the state of Michigan revealed no difference in the rate of SSI when comparing chlorhexidine-alcohol-based to PI-alcohol-based solutions. 12 Likewise, they found no difference in a larger comparison on colorectal surgery comparing alcohol-based to aqueous-based solutions. A more recent noninferiority randomized trial comparing PI-alcohol to chlorhexidine-alcohol failed to show noninferiority of the PI-alcohol solution.…”

Section: Discussionmentioning

confidence: 99%

Antiseptic Skin Preparation Agents to Prevent Surgical Site Infection in Colorectal Surgery: A 3-Armed Randomized Controlled Trial

Reid

Stephensen

Carroll

et al. 2021

Diseases of the Colon &Amp; Rectum

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BACKGROUND:There is much debate surrounding the ideal antiseptic skin preparation agent to reduce postoperative surgical site infection. International guidelines suggest that chlorhexidine-and alcoholcontaining compounds have superior efficacy. However, there are minimal clinical trials specifically looking at skin preparation agents for colorectal surgery. OBJECTIVE:The aim of this study was to compare the efficacy of chlorhexidine in alcohol versus povidoneiodine in alcohol versus povidone-iodine in aqueous solution for the prevention of surgical site infection in colorectal surgery.

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Chlorhexidine With Isopropyl Alcohol Versus Iodine Povacrylex With Isopropyl Alcohol and Alcohol- Versus Nonalcohol-Based Skin Preparations

Cited by 12 publications

References 12 publications

Reducing Surgical Site Infection in Pediatric Scoliosis Surgery: A Multidisciplinary Improvement Program and Prospective 4-Year Audit

Reducing Surgical Site Infection in Pediatric Scoliosis Surgery: A Multidisciplinary Improvement Program and Prospective 4-Year Audit

Alternatives to antibiotics for prevention of surgical infection

Antiseptic Skin Preparation Agents to Prevent Surgical Site Infection in Colorectal Surgery: A 3-Armed Randomized Controlled Trial

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