Perioperative Skin Preparation and Draping in Modern Total Joint Arthroplasty: Current Evidence

Markatos, Konstantinos; Kaseta, Maria Kyriaki; Nikolaou, Vasileios S.

doi:10.1089/sur.2014.097

Cited by 31 publications

(13 citation statements)

References 34 publications

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“…Recent evidence advocates for dual‐agent skin antiseptics (eg, CHG and PI) rather than a single agent . Antiseptic agents in combination with alcohol were found to be the most effective in reducing skin contaminants . A literature review by Privitera showed that skin preps that included a combination of CHG and alcohol are effective because the alcohol is fast‐acting and the CHG provides a longer residual effect for reduction of microbes.…”

Section: Strategies To Prevent Ssismentioning

confidence: 99%

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Perioperative Strategies for Surgical Site Infection Prevention

Bashaw¹

2018

AORN Journal

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To provide the learner with knowledge of best practices related to perioperative strategies for surgical site infection (SSI) prevention. OBJECTIVES1. Identify contributing patient factors related to SSI development. 2. Identify contributing procedural factors related to SSI development. 3. Describe perioperative best practices to help decrease the incidence of SSIs. 4. Describe two types of skin antiseptic agents that may be used for perioperative skin preparation. ACCREDITATIONAORN is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.ABSTRACT Surgical site infections (SSIs) are some of the most common and costly health care-associated infections. Although the rate of SSIs has declined significantly in the past decade, patient safety remains at risk. Perioperative nurses employ a variety of evidence-based best practices to prevent SSIs and facilitate a safe surgical experience for their patients, including hand hygiene, preoperative patient skin antisepsis, and antimicrobial irrigation. This article explores the causes of SSIs, such as modifiable and nonmodifiable patient factors and preoperative, intraoperative, and postoperative procedural factors, and discusses some of the specific recommended strategies related to the prevention of SSIs that perioperative nurses can initiate in their workplace.

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Section: Strategies To Prevent Ssismentioning

confidence: 99%

“…Perioperative personnel create and maintain the sterile field and perform the skin preparation. After the perioperative nurse or designee completes the antimicrobial cleansing of the surgical site, the scrubbed team members drape the surgical area with sterile towels and sheets to provide a sterile area for execution of the surgical procedure …”

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confidence: 99%

Perioperative Strategies for Surgical Site Infection Prevention

Bashaw¹

2018

AORN Journal

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“…Therefore, it is difficult to ascertain the effects of chlorhexidine-based agents on the prevention of PJI in primary THA patients based on the results of previous studies. At present, the strength of the evidence for preoperative chlorhexidine bathing for the prevention of PJI after primary THA remains uncertain, and there is a lack of consistent suggestion and consensus in the relevant literature [ 26 , 27 , 28 , 29 ]. To the best of our knowledge, this comparative study is the first to specifically investigate the effects of preoperative chlorhexidine bathing on reducing the incidence rate of PJI after primary THA.…”

Section: Introductionmentioning

confidence: 99%

The Prevention of Periprosthetic Joint Infection in Primary Total Hip Arthroplasty Using Pre-Operative Chlorhexidine Bathing

Lai

Lee

et al. 2021

JCM

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Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is a devastating complication. The aim of this study was to investigate whether preoperative bathing using chlorhexidine gluconate (CHG) before THA can effectively reduce the postoperative PJI rate. A total of 933 primary THA patients, with the majority being female (54.4%) were included in the study. Primary THA patients who performed preoperative chlorhexidine bathing were assigned to the CHG group (190 subjects), and those who did not have preoperative chlorhexidine bathing were in the control group (743 subjects). The effects of chlorhexidine bathing on the prevention of PJI incidence rates were investigated. Differences in age, sex, and the operated side between the two groups were not statistically significant. Postoperative PJI occurred in four subjects, indicating an infection rate of 0.43% (4/933). All four infected subjects belonged to the control group. Although the PJI cases were significantly more in the control group than in the CHG group, statistical analysis revealed no statistical significance in the risk of PJI occurrence between the two groups (p = 0.588). Preoperative skin preparation by bathing with a 2% chlorhexidine gluconate cleanser did not produce significant effects on the prevention of postoperative PJI in primary THA.

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“…7 Iodophor impregnated adhesive dressings, such as Ioban are commonly used in shoulder surgeries as a part of the sterile draping process. 12,13 One study regarding hip procedures showed that using this type of drape caused a statistically significant reduction in the number of bacteria at the surgical site. 12 It is often noted during the authors' operative cases that there are grossly visible particles present on the adhesive surface of the dressing following removal of the dressing.…”

Section: Introductionmentioning

confidence: 99%

Removal of Ioban May Pull Bacteria to the Surface of the Skin: Lessons Learned

Lytle

McCoy

Smeltzer

et al. 2020

Spartan Medical Research Journal

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CONTEXT CONTEXT Cutibacterium acnes (C. Acnes, formerly known as Propionibacterium acnes) are slow growing, gram positive, anaerobic bacilli. C. acnes are found in many locations, both as part of normal skin flora, as well as a contaminant of environmental surfaces. These bacteria have been associated with prosthetic joint infections of the shoulder, and it has been challenging to prevent such infections for a variety of reasons. The purpose of this quality improvement project was to investigate whether the surgical adhesive dressing Ioban could pull subcutaneous C. acnes bacteria from the surgical field. METHODS METHODS During this quality improvement project, a convenience sample of 16 adult volunteers were gathered from other residency departments and from medical students at our hospital. The volunteers were used to take samples from two sites on each shoulder. The shoulder sites were prepped and covered with iodine-impregnated dressings. RESULTS RESULTS There were 26 of 64 (40.6%) samples in the no Ioban group that grew C. acnes. The Ioban group had 37 of 64 (57.8%) samples found to be positive for C. acnes growth. During this project, we identified several key points that could be useful to future researchers working in community hospitals. We describe these lessons concerning ongoing communication with lab and research departments, offering volunteers compensation to participate, interacting with departments unaccustomed to research, and development of a clear methodology. CONCLUSIONS CONCLUSIONS This was the first time our department had conduct a project utilizing the laboratory as well as volunteers. This came with unforeseen challenges which caused significant time delays. We believe that by highlighting these lessons for future researchers, they might avoid such problems during project activities.

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Perioperative Skin Preparation and Draping in Modern Total Joint Arthroplasty: Current Evidence

Cited by 31 publications

References 34 publications

Perioperative Strategies for Surgical Site Infection Prevention

Perioperative Strategies for Surgical Site Infection Prevention

The Prevention of Periprosthetic Joint Infection in Primary Total Hip Arthroplasty Using Pre-Operative Chlorhexidine Bathing

Removal of Ioban May Pull Bacteria to the Surface of the Skin: Lessons Learned

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