Disinfection with single or double usage of new antiseptic olanexidine gluconate in general surgery: a randomized study

Yamamoto, Manabu; Hara, Kazushi; Sugezawa, Ken; Uejima, Chihiro; Tanio, Akimitsu; Tada, Yoichiro; Shishido, Yuji; Miyatani, Kozo; Hanaki, Takehiko; Kihara, Kyoichi; Matsunaga, Tomoyuki; Tokuyasu, Naruo; Takano, Shuichi; Sakamoto, Teruhisa; Honjo, Soichiro; Fujiwara, Yoshiyuki

doi:10.1007/s00423-020-02007-6

Cited by 4 publications

(7 citation statements)

References 33 publications

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“…Five studies evaluated the effect on SSI prevention. 26 , 55 , 56 , 57 , 58 Two studies were RCTs, and three were retrospective observational studies. One study included children, and the remaining four studies included adults.…”

Section: Resultsmentioning

confidence: 99%

“…One study compared OLG, PVP‐I, and CHG, 57 two studies compared OLG to PVP‐I, 26 , 56 and one study had no comparator. 58 One study compared a single application of OLG to two applications of OLG 55 (Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

“…One RCT 55 compared single and double application of OLG (concentration unknown) for disinfection during laparoscopic or robotic standby gastrointestinal surgery in adults. The incident rate of all SSIs within 30 days after surgery was not significantly different between the two groups, and single application was noninferior to double application (3.1% in the single application group vs. 2.0% in the double application group, p = 0.537).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies evaluated the effect on SSI prevention 26,55–58 . Two studies were RCTs, and three were retrospective observational studies.…”

Section: Resultsmentioning

confidence: 99%

“…One study compared OLG, PVP-I, and CHG, 57 two studies compared OLG to PVP-I, 26,56 and one study had no comparator. 58 One study 55 (Table 5).…”

Section: Prevention Of Ssimentioning

confidence: 99%

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Clinical application of skin antisepsis using aqueous olanexidine: a scoping review

Shinzato

Sakihara

Kishihara

et al. 2022

Acute Medicine & Surgery

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Surgical site infections (SSIs) and catheter‐related bloodstream infections (CRBSIs) caused by bacteria from surfaces poorly disinfected with chlorhexidine gluconate (CHG) and povidone‐iodine (PVP‐I) are increasing. Olanexidine gluconate (OLG) was developed in 2015 in Japan to prevent SSI and CRBSI caused by bacteria resistant to CHG and PVP‐I. This scoping review aimed to identify the knowledge gap between what is known and what is not known about the disinfection efficacy of OLG. We searched MEDLINE through PubMed, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the International Clinical Trials Registry Platform search database, ClinicalTrials.gov , and the Web‐based database of Japanese medical articles for works published to July 18, 2021. Manual reference searches were also carried out. A total of 131 studies were screened. Forty‐seven studies were included in this review and classified into two major categories: studies on pharmacological effects and spectrum ( n = 29) and studies on clinical and adverse effects ( n = 18). Olanexidine gluconate showed bactericidal activity against methicillin‐resistant Staphylococcus aureus and vancomycin‐resistant enterococci, in addition to common Gram‐positive and Gram‐negative bacteria. In clinical settings, although there is limited evidence on SSI prevention, 1.5% OLG might be more effective than 10% PVP‐I and 1% CHG in preventing SSI. However, the clinical usefulness of OLG is unclear due to the limited number of clinical studies. Also, clinical research is limited to studies targeting SSI prevention, and there are no clinical studies on CRBSI. Further clinical studies are needed on SSI and CRBSI prevention.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Five studies evaluated the effect on SSI prevention 26,55–58 . Two studies were RCTs, and three were retrospective observational studies.…”

Section: Resultsmentioning

confidence: 99%

“…One study compared OLG, PVP-I, and CHG, 57 two studies compared OLG to PVP-I, 26,56 and one study had no comparator. 58 One study 55 (Table 5).…”

Section: Prevention Of Ssimentioning

confidence: 99%

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Clinical application of skin antisepsis using aqueous olanexidine: a scoping review

Shinzato

Sakihara

Kishihara

et al. 2022

Acute Medicine & Surgery

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Comparison of olanexidine versus povidone‐iodine as a preoperative antiseptic for reducing surgical site infection in both scheduled and emergency gastrointestinal surgeries: A single‐center randomized clinical trial

Umemura

Sasaki

Fujiwara³

et al. 2023

Annals of Gastroent Surgery

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AimSurgical site infection (SSI) is one of the most common postoperative complications in gastrointestinal surgery. To clarify the superiority of 1.5% olanexidine, we conducted a randomized prospective clinical trial that enrolled patients undergoing gastrointestinal surgery with operative wound classes II–IV.MethodsTo evaluate the efficacy of 1.5% olanexidine in preventing SSIs relative to 10% povidone‐iodine, we enrolled 298 patients in each group. The primary outcome was a 30‐day SSI, and the secondary outcomes were incidences of superficial and deep incisional SSI and organ/space SSI. In addition, subgroup analyses were performed.ResultsThe primary outcome of the overall 30‐day SSI occurred in 38 cases (12.8%) in the 1.5% olanexidine group and in 53 cases (18.0%) in the 10% povidone‐iodine group (adjusted risk ratio: 0.716, 95% confidence interval: 0.495–1.057, p = 0.083). Organ/space SSI occurred in 18 cases (6.1%) in the 1.5% olanexidine group and in 31 cases (10.5%) in the 10% povidone‐iodine group, with a significant difference (adjusted risk ratio: 0.587, 95% confidence interval: 0.336–0.992, p = 0.049). Subgroup analyses revealed that SSI incidences were comparable in scheduled surgery (relative risk: 0.809, 95% confidence interval: 0.522–1.254) and operative wound class II (relative risk: 0.756, 95% confidence interval: 0.494–1.449) in 1.5% olanexidine group.ConclusionOur study revealed that 1.5% olanexidine reduced the 30‐day overall SSI; however, the result was not significant. Organ/space SSI significantly decreased in the 1.5% olanexidine group. Our results indicate that 1.5% olanexidine has the potential to prevent SSI on behalf of povidone‐iodine.

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Propensity-matched analysis of the efficacy of olanexidine gluconate versus chlorhexidine-alcohol as an antiseptic agent in thoracic esophagectomy

et al. 2022

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Background In the present matched-cohort study, we investigated the efficacy of olanexidine gluconate in comparison with chlorhexidine-alcohol as an antiseptic agent in thoracic esophagectomy. Methods A total of 372 patients with esophageal cancer who were scheduled to undergo thoracic esophagectomy between 2016 and 2018 were assigned to one of two groups based on the preoperative antiseptic agent used in thoracic esophagectomy. We investigated the incidence of surgical site infectious complications in the propensity-matched cohort. Results Based on the propensity score, 116 patients prepared with 1.5% olanexidine gluconate and 114 patients prepared with 1.0% chlorhexidine-alcohol as surgical skin antisepsis were selected. No significant intergroup differences were observed with respect to incisional surgical site infection (0.8% in the olanexidine group versus 0.8% in the chlorhexidine group) and deep fascial/organ space surgical site infection (1.7%/10.3% in the olanexidine group versus 3.5%/15.7% in the chlorhexidine group, p = 0.39/p = 0.03). Notably, the respective incidences of surgical site infection except anastomotic leakage were 1.7% and 7.0% in the olanexidine and chlorhexidine groups (p = 0.04). Conclusions Olanexidine gluconate was well tolerated and significantly reduced incidence of surgical site infection except anastomotic leakage in comparison with chlorhexidine-alcohol as an antiseptic agent in thoracic esophagectomy with three-field lymph node dissection.

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Disinfection with single or double usage of new antiseptic olanexidine gluconate in general surgery: a randomized study

Cited by 4 publications

References 33 publications

Clinical application of skin antisepsis using aqueous olanexidine: a scoping review

Clinical application of skin antisepsis using aqueous olanexidine: a scoping review

Comparison of olanexidine versus povidone‐iodine as a preoperative antiseptic for reducing surgical site infection in both scheduled and emergency gastrointestinal surgeries: A single‐center randomized clinical trial

Propensity-matched analysis of the efficacy of olanexidine gluconate versus chlorhexidine-alcohol as an antiseptic agent in thoracic esophagectomy

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