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PubMed1963

Skin antisepsis.

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Anti-Infective Agents, Local↗
PubMed1997

Antiseptic effect of povidone-iodine solution on abdominal skin during surgery and on thyroid-gland-related substances.

No definite guidelines have been published concerning the suitable exposure time and frequency of skin antisepsis of the operative field. In the present study, the antiseptic effect of a single use (single-application group) of 10% povidoneiodine solution for skin antisepsis was compared with its triple use (triple-application group). The exposure time was 2 min for both groups. Moreover, the effects on blood levels of total iodine and thyroid-gland-related substances were evaluated. High antiseptic efficacy was obtained in both groups, indicating that our antiseptic method to disinfect the operative field is effective. Slightly better results were obtained from the triple-application group, although the difference was not statistically significant. Blood levels of total iodine and thyroid-gland-related substances remained within the normal range in all cases. However, in cases receiving a large amount of 10% povidone-iodine solution a transient elevation in blood total iodine was observed. Thus, the 10% povidone-iodine solution is considered to be safe and effective for skin antisepsis of the operative field when applied repeatedly in a small amount per dose with an exposure time of about 2 min.

Abdomen↗
PubMed1997

Antiseptic effects at injection sites.

To our knowledge, there are no published papers detailing antisepsis for injection sites. In view of this, the efficacies of povidone-iodine (PVP-I) ethanol solution and chlorhexidine (CH) ethanol, the agents most commonly used for antisepsis of the operative field, were compared. Before and after the injection site was disinfected with either of these antiseptics, specimens of indigenous bacteria on the skin were collected by the cylinder scrub method, and the bacteria reduction rate and the reduction factor (RF) were determined to evaluate the efficacy of antisepsis. The bacteria reduction rate and RF value obtained for PVP-I ethanol were 95.1 +/- 11.2 and 2.1 +/- 0.9% and those for CH ethanol were 93.5 +/- 9.3 and 1.8 +/- 0.9%. Since there were individual differences in cell count before antisepsis, no significant difference was seen in bactericidal activity. However, slightly more favorable results were obtained with PVP-I ethanol. Although it is impossible to eradicate completely the indigenous microbes with currently available methods, it is considered important for the prevention of infection of the injection site to decrease bacterial counts as much as possible.

Anti-Infective Agents, Local↗
PubMed2003

Antiseptic wound ventilation with a gas diffuser: a new intraoperative method to prevent surgical wound infection?

Postoperative wound infections are often a result of peri-operative contamination by Staphylococcus aureus. With a new insufflation device, a gas diffuser, it has become possible to establish a local micro-environment of almost 100% carbon dioxide in an open surgical wound. The device enables ventilation of the wound with an antiseptic agent, which in gaseous form can be delivered as a low uniform dose to all parts of the wound. The use of carbon dioxide (CO2) as a carrier gas eliminates possible inflammability of an antiseptic agent and helps to concentrate it to the site of interest by gravity. Using the above delivery system we have demonstrated the antibacterial effect of gaseous ethanol on S. aureus inoculated on sterile filter disks and blood agar plates, respectively. Ethanol is a very potent antiseptic agent with known properties, which makes it suitable for testing the maximal decontamination level. On filter disks, CO2 carrying vapour from a 95% ethanol solution decreased the number of colony-forming units after 5 min of exposure (P=0.04), and killed all bacteria within 10-15 min (P<0.001). In the presence of organic material, i.e. on exposed blood agar plates, the colony size decreased with exposure time, and no colonies were detected after 60 min of exposure (P<0.001). Antiseptic gas derived from 70% ethanol solution was less effective than that from 95% ethanol (P<0.001). CO2 humidified with water did not have a significant effect on number or size of the colonies. Our findings suggest that intraoperative wound antisepsis with a gas mixture of CO2 and an antiseptic agent delivered with a gas diffuser, may be a simple method to reduce the risk of postoperative wound infection.

Administration, Cutaneous↗
PubMed1988

The Lister steam spray in Aberdeen.

A Lister 'steam spray producer' in the possession of Aberdeen University is described. The introduction of antiseptic surgery to Aberdeen by Alexander Ogston and the subsequent adoption of the spray and its enthusiastic use by him is recounted, with emphasis on the final years of its employment as part of the antiseptic ritual.

Antisepsis↗
PubMedDate not supplied

Polyvinyl pyrrolidone-iodine liposome hydrogel improves epithelialization by combining moisture and antisepis. A new concept in wound therapy.

Moist treatment of wounds has been shown to improve epithelialization, however at an increased risk of bacterial infection. In this monocentric, randomized, open, phase II pilot study of polyvinyl pyrrolidone-iodine, a well-established topical antiseptic was tested in a new liposomal complexed form in patients receiving meshed skin grafts after burns or reconstructive procedures. Mesh skin graft sites of 36 patients were dressed either with the new polyvinyl-pyrrolidone-iodine liposome hydrogel formulation (Betasom hydrogel) (n = 21), or chlorhexidine-gauze (n = 15). After the first dressing change, wounds were assessed daily and documented every other day until they were healed. Methods of analysis included clinical assessment, photoplanimetry (rate of epithelialization), impedance measurement (moisture of surface and wound healing quality), patient's assessment of pain and other sensations, and thyroid hormones (T3, T4, and TSH). The rate of epithelialization was improved with Betasom hydrogel compared to chlorhexidine-gauze on day 11 (96.3% vs. 75.9% p = 0.056) and significantly on day 13 (100% vs. 82.3% p = 0.005), respectively. Impedance measurements showed an earlier return to normal values (day 9) in Betasom-hydrogel-treated wounds as opposed to chlorhexidine treatment (day 11). Clinical assessment indicated significantly better antiseptic efficacy (p = 0.002) and wound healing quality (p = 0.004) of Betasom hydrogel. Graft loss occurred at a significantly lower rate in Betasom treatment (n = 1; 5%), than in chlorhexidine treatment (n = 5; 35.7%) (p = 0.001). No relevant adverse events or clinically relevant changes of thyroid hormones were observed with Betasom hydrogel. The rationale of this new polyvinyl pyrrolidone-iodine liposomal formulation was based on the properties of liposomes that provide higher moisture to the wound surface, release PVP-iodine at a low rate, and target the substance more exactly by interaction with the cell surface. These initial clinical results show earlier epithelialization and better healing in wounds treated with polyvinyl pyrrolidone-iodine liposome hydrogel, which combines moisture and antisepsis, compared to wounds treated with a conventional antiseptic chlorhexidine-gauze.

Adult↗
PubMed2005

No need for preoperative antiseptics in elective outpatient plastic surgical operations: a prospective study.

The development of antisepsis in the late nineteenth and early twentieth centuries revolutionized health care. The time-honored technique of skin preparation is to scrub the entire operative area of the patient for 5 to 7 minutes with a germicidal detergent solution and then paint the region with an antimicrobial solution of either tincture of povidone-iodine (Betadine) or chlorhexidine. Although antiseptics result in lower colony counts on the skin, they have side effects and higher cost in relation to normal saline. The authors have prepared patients by showering the surgical site with soap and water and rinsing it with normal saline, in 905 cases of outpatient, clean-wound plastic surgery. In another 905 cases that served as the control group, the traditional method of preoperative shower and scrub with chlorhexidine or Betadine was used. In both groups, there was no incidence of wound infection.

Adult↗
PubMed2004

Preoperative skin antiseptics for preventing surgical wound infections after clean surgery.

BACKGROUND: Approximately 15% of elective surgery patients and 30% of patients receiving contaminated or dirty surgery are estimated to develop post-operative wound infections. The costs of surgical wound infection can be considerable in financial as well as social terms. Preoperative skin antisepsis is performed to reduce the risk of post-operative wound infections by removing soil and transient organisms from the skin. Antiseptics are thought to be both toxic to bacteria and aid their mechanical removal. The effectiveness of preoperative skin preparation is thought to be dependent on both the antiseptic used and the method of application, however it is unclear whether preoperative skin antisepsis actually reduces post-operative wound infection and if so which antiseptic is most effective. OBJECTIVES: To determine whether preoperative skin antisepsis reduces post-operative surgical wound infection. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Trials Register and the Cochrane Central Register of Controlled Trials in April 2004. In addition we handsearched journals, conference proceedings and bibliographies. SELECTION CRITERIA: Randomised controlled trials evaluating the use of preoperative skin antiseptics applied immediately prior to incision in clean surgery. There were no restrictions based on language, date or publication status. DATA COLLECTION AND ANALYSIS: Three reviewers independently undertook data extraction and assessment of study quality. Pooling was inappropriate and trials are discussed in a narrative review. MAIN RESULTS: We identified six eligible RCTs evaluating preoperative antiseptics. There was significant heterogeneity in the comparisons and the results could not be pooled. In one study, infection rates were significantly lower when skin was prepared using chlorhexidine compared with iodine. There was no evidence of a benefit in four trials associated with the use of iodophor impregnated drapes. REVIEWERS' CONCLUSIONS: There is insufficient research examining the effects of preoperative skin antiseptics to allow conclusions to be drawn regarding their effects on post-operative surgical wound infections. Further research is needed.

Anti-Infective Agents, Local↗