Are three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patients
Abstract Background Preoperative skin antisepsis is an essential component of safe surgery. However, it is unclear how many antiseptic paints are needed to eliminate bacteria prior to incision. This study compared microbial skin counts after two and three antiseptic paints. Methods We conducted a pr...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13756-020-00780-z |
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| author | Jan A. Roth Cyrill Schwab Andrew Atkinson Markus von Flüe Christoph Kettelhack Friedrich S. Eckstein Manuel Battegay Steffi Klimke Reno Frei Andreas F. Widmer |
| author_facet | Jan A. Roth Cyrill Schwab Andrew Atkinson Markus von Flüe Christoph Kettelhack Friedrich S. Eckstein Manuel Battegay Steffi Klimke Reno Frei Andreas F. Widmer |
| author_sort | Jan A. Roth |
| collection | DOAJ |
| description | Abstract Background Preoperative skin antisepsis is an essential component of safe surgery. However, it is unclear how many antiseptic paints are needed to eliminate bacteria prior to incision. This study compared microbial skin counts after two and three antiseptic paints. Methods We conducted a prospective cohort study in non-emergency patients receiving a cardiac/abdominal surgery with standardized, preoperative skin antisepsis consisting of an alcoholic compound and either povidone iodine (PI) or chlorhexidine (CHX). We obtained three skin swabs from the participant’s thorax/abdomen using a sterile template with a 25 cm2 window: After collection of the first swab prior to skin antisepsis, and once the second and third application of PI/CHX had dried out, we obtained a second and third swab, respectively. Our primary outcome was the reduction in microbial skin counts after two and three paints of PI/CHX. Results Among the 239 enrolled patients, there was no significant difference in the reduction of mean square root-transformed microbial skin counts with three versus two paints (P = 0.2). But distributions of colony forming units (CFUs) decreased from paint 2 to 3 in a predefined analysis (P = 0.002). There was strong evidence of an increased proportion of patients with zero CFU after paint 3 versus paint 2 (P = 0.003). We did not identify risk factors for insufficient reduction of microbial skin counts after two paints, defined as the detection of > 5 CFUs and/or ≥ 1 pathogens. Conclusions In non-emergency surgical patients, three antiseptic paints may be superior to two paints in reducing microbial skin colonization prior to surgery. |
| first_indexed | 2024-12-23T21:18:21Z |
| format | Article |
| id | doaj.art-0587467f2e6b4fd4be4a437847fa4389 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-23T21:18:21Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-0587467f2e6b4fd4be4a437847fa43892022-12-21T17:30:49ZengBMCAntimicrobial Resistance and Infection Control2047-29942020-07-01911810.1186/s13756-020-00780-zAre three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patientsJan A. Roth0Cyrill Schwab1Andrew Atkinson2Markus von Flüe3Christoph Kettelhack4Friedrich S. Eckstein5Manuel Battegay6Steffi Klimke7Reno Frei8Andreas F. Widmer9Division of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDepartment of Infectious Diseases and Hospital Epidemiology, University Hospital Bern, University of BernUniversity of BaselUniversity of BaselUniversity of BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselDivision of Infectious Diseases and Hospital Epidemiology, University Hospital BaselAbstract Background Preoperative skin antisepsis is an essential component of safe surgery. However, it is unclear how many antiseptic paints are needed to eliminate bacteria prior to incision. This study compared microbial skin counts after two and three antiseptic paints. Methods We conducted a prospective cohort study in non-emergency patients receiving a cardiac/abdominal surgery with standardized, preoperative skin antisepsis consisting of an alcoholic compound and either povidone iodine (PI) or chlorhexidine (CHX). We obtained three skin swabs from the participant’s thorax/abdomen using a sterile template with a 25 cm2 window: After collection of the first swab prior to skin antisepsis, and once the second and third application of PI/CHX had dried out, we obtained a second and third swab, respectively. Our primary outcome was the reduction in microbial skin counts after two and three paints of PI/CHX. Results Among the 239 enrolled patients, there was no significant difference in the reduction of mean square root-transformed microbial skin counts with three versus two paints (P = 0.2). But distributions of colony forming units (CFUs) decreased from paint 2 to 3 in a predefined analysis (P = 0.002). There was strong evidence of an increased proportion of patients with zero CFU after paint 3 versus paint 2 (P = 0.003). We did not identify risk factors for insufficient reduction of microbial skin counts after two paints, defined as the detection of > 5 CFUs and/or ≥ 1 pathogens. Conclusions In non-emergency surgical patients, three antiseptic paints may be superior to two paints in reducing microbial skin colonization prior to surgery.http://link.springer.com/article/10.1186/s13756-020-00780-zAntisepsisDisinfectionInfection preventionMethodSurgery |
| spellingShingle | Jan A. Roth Cyrill Schwab Andrew Atkinson Markus von Flüe Christoph Kettelhack Friedrich S. Eckstein Manuel Battegay Steffi Klimke Reno Frei Andreas F. Widmer Are three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patients Antimicrobial Resistance and Infection Control Antisepsis Disinfection Infection prevention Method Surgery |
| title | Are three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patients |
| title_full | Are three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patients |
| title_fullStr | Are three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patients |
| title_full_unstemmed | Are three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patients |
| title_short | Are three antiseptic paints needed for safe preparation of the surgical field? A prospective cohort study with 239 patients |
| title_sort | are three antiseptic paints needed for safe preparation of the surgical field a prospective cohort study with 239 patients |
| topic | Antisepsis Disinfection Infection prevention Method Surgery |
| url | http://link.springer.com/article/10.1186/s13756-020-00780-z |
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