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The Impact of Preoperative Skin Disinfection on Preventing lntraoperative Wound Contamination

Published online by Cambridge University Press:  21 June 2016

Richard A. Garibaldi ,
Deborah Skolnick ,
Trudy Lerer ,
Andrea Poirot ,
Jeffrey Graham ,
Edward Krisuinas  and
Robert Lyons
Richard A. Garibaldi*
Affiliation:
Departments of Medicine, University of Connecticut Health Center, Farmington Connecticut and St. Francis Hospital and Medical Center, Hartford, Connecticut
Deborah Skolnick
Affiliation:
Departments of Medicine, University of Connecticut Health Center, Farmington Connecticut and St. Francis Hospital and Medical Center, Hartford, Connecticut
Trudy Lerer
Affiliation:
Departments of Medicine, University of Connecticut Health Center, Farmington Connecticut and St. Francis Hospital and Medical Center, Hartford, Connecticut
Andrea Poirot
Affiliation:
Departments of Medicine, University of Connecticut Health Center, Farmington Connecticut and St. Francis Hospital and Medical Center, Hartford, Connecticut
Jeffrey Graham
Affiliation:
Departments of Medicine, University of Connecticut Health Center, Farmington Connecticut and St. Francis Hospital and Medical Center, Hartford, Connecticut
Edward Krisuinas
Affiliation:
Departments of Medicine, University of Connecticut Health Center, Farmington Connecticut and St. Francis Hospital and Medical Center, Hartford, Connecticut
Robert Lyons
Affiliation:
Departments of Medicine, University of Connecticut Health Center, Farmington Connecticut and St. Francis Hospital and Medical Center, Hartford, Connecticut
*
Department of Medicine, University of Connecticut Health Center, Farmington, CT 06032
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Abstract

The efficacy of total body showering and incision site scrub with disinfectant agents was evaluated in a randomized, prospective study of 575 patients undergoing selected surgical procedures. Patients who showered twice with 4% chlorhexidine gluconate had lower mean colony counts of skin bacteria at the surgical incision site in the operating room prior to the final scrub than patients who showered twice with povidone-iodine solution or medicated bar soap. Patients in the chlor-hexidine group had no growth on 43% of the incision site skin cultures compared with 16% in the povidone-iodine group and 6% in the soap and water group. Patients who showered and who were scrubbed with chlorhexidine also had lower rates of intraoperative wound contamination. Bacteria were recovered from the wounds of 4% of patients using this regimen compared with 9% for patients who used povidone-iodine and 15% for patients who showered with medicated soap and water and were scrubbed with povidone-iodine. We noted no difference in surgery-specific infection rates among patients in the three treatment groups; however, our sample sizes were too small to evaluate this outcome parameter adequately.

These data suggest that preoperative showering and scrubbing with chlorhexidine is an effective regimen to reduce extrinsic intraoperative contamination of the surgical wound from skin bacteria. The efficacy of this regimen to prevent postoperative wound infection needs to be evaluated in a well-designed, carefully controlled prospective trial with adequate numbers of patients to achieve statistically valid conclusions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 9 , Issue 3 , March 1988 , pp. 109 - 113
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

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