Comparison of Aqueous and Alcohol-based Agents for Presurgical Skin Preparation Methods in Mice

Abstract

Preparing the skin of rodents for surgery often involves multiple applications of antiseptic agents. However, fewer applications may achieve the same antiseptic outcome. We evaluated the antimicrobial efficacy and effects on intraoperative body temperature of various surgical scrub agents, including novel waterless alcohol-based (WAB) options. Prior to ventral laparotomy, female C57BL/6 mice were treated with 0.9% saline (control); 70% ethanol; 10% povidone-iodine alternated with saline or 70% ethanol; 2% chlorhexidine digluconate alternated with saline or 70% ethanol; or 1 of 3 WAB products-commercial surgical scrub A, commercial surgical scrub B, or a common commercial hand sanitizer. Core temperatures were recorded, and aerobic culture swabs were collected from the surgical site at multiple time points. Intraoperative temperature trajectories for animals treated with scrub B, 10% povidone-iodine with saline, or hand sanitizer did not differ from saline (control). Temperature trajectories of mice treated with other scrub agents did differ significantly from saline. Bacteria were not detected at the operative site after 3 scrubs of 70% ethanol or 10% povidone-iodine alternated with ethanol, 2 scrubs of scrub A or B, 1 scrub of hand sanitizer, and both 1 and 3 scrubs of 2% chlorhexidine alternated with ethanol. Scrub B and 2% chlorhexidine-ethanol demonstrated prolonged antibacterial efficacy. Histology of corresponding haired skin sections revealed no differences in postoperative healing between groups, and no postoperative infections occurred. These results indicate that various novel WAB disinfectants, particularly scrub B (61% ethanol and 1% chlorhexidine gluconate), mitigate intraoperative temperature effects associated with several traditional agents and combinations. Furthermore, reduction of skin bacterial load without adverse effects on healing was seen with fewer than triplicate applications of most tested agents. Ultimately effective skin preparation can be achieved by using only 1 or 2 applications of scrub, thus rendering the triplicate skin-prep method unnecessary in laboratory mice.

Comparison of the effect of isopropyl alcohol and chlorhexidine solution rinses on body temperature of female cats undergoing sterilization surgery

“…In one study comparing various aqueous and alcohol-based agents for aseptic preparation of mice prior to a 15 min surgery, it was found that use of a 70% isopropyl alcohol rinse resulted in a more rapid decrease in body temperature than other rinses, including chlorhexidine solution. 14 However, all mice ended up at a similar temperature by the conclusion of the surgery. Unlike this study, no surgical drapes were used.…”

“…10–13 In the clinical experience of one author (RK) some high-quality, high-volume spay–neuter (HQHVSN) clinicians use a chlorhexidine rinse instead of alcohol in an effort to reduce the risk of perioperative hypothermia, particularly in their pediatric patients. However, the effect of alcohol rinses on mice is nuanced, with a rapid decrease in temperature followed by a rebound effect, 14,15 and it is unclear whether the use of an alcohol rinse would affect cats similarly to mice.…”

Evaluation of 4 Presurgical Skin Preparation Methods in Mice

“…4,7,34 Although these methods are generally accepted as best current practice, the effectiveness of presurgical skin preparation methods in rodents and their effects on surgical wound healing has recently prompted investigation. 11 The goal of the present study was to evaluate 4 skin preparation methods for their ability to achieve antisepsis and to assess their effects on incisional wound healing. The data reported herein indicate that all methods were equally effective in achieving asepsis and resulted in satisfactory wound healing by day 7 after surgery.…”

Evaluation of 3 Alcohol-based Agents for Presurgical Skin Preparation in Mice

“…39 Triplicate application using alternating antiseptic scrub or solution and rinse has been the long-time standard in the veterinary field for preoperative skin preparation and is also the standard requirement for rodent surgery. 3,7,15,26 A recent evaluation of triplicate application of skin antiseptic preparation agents found that skin preparation can be achieved with 1 or 2 applications of antiseptic preparation. 7 Another study indicated that a different waterless alcohol-based agent was effective for antiseptic preparation after a single application in dogs.…”

“…3,7,15,26 A recent evaluation of triplicate application of skin antiseptic preparation agents found that skin preparation can be achieved with 1 or 2 applications of antiseptic preparation. 7 Another study indicated that a different waterless alcohol-based agent was effective for antiseptic preparation after a single application in dogs. 20 This current study further explores alternative antiseptic skin preparation agents for mice that are used in the medical profession.…”