Skin preparation before surgery: options and evidence

Surgical Infections
Feroze Sidhwa, Kamal M F Itani

Abstract

Despite many advances in surgical asepsis, surgical site infection (SSI) remains a challenging and costly problem. Decontamination of the skin with an antiseptic agent is standard practice before any trans-cutaneous invasive procedure, but the antiseptic agent of choice to best reduce the risk of SSI remains controversial. Review of relevant literature. Many randomized controlled trials (RCTs) have evaluated chlorhexidine-based and iodine-based preparation solutions, with and without an alcohol component. Most of these trials are underpowered to detect differences in SSI rates. The largest modern RCT showed that a chlorhexidine-isopropyl alcohol preparation reduced the risk of SSI substantially compared with a povidone-iodine preparation without alcohol in clean-contaminated surgery. Many smaller RCTs have shown that chlorhexidine-isopropyl alcohol is superior to povidone-iodine plus isopropyl alcohol or iodine povacrylex plus isopropyl alcohol in pre-operative skin decontamination; whether or not this translates into lower SSI rates is unknown. A mixed treatment comparison of 10 RCTs concluded that alcohol-based preparations have a 98% probability of reducing the risk of SSI more effectively than aqueous-based preparations. No...Continue Reading

References

Nov 1, 1975·American Journal of Surgery·T J Krizek, M C Robson
Apr 1, 1967·British Medical Journal·J Lister
Aug 1, 1995·American Journal of Infection Control·E L Larson
Apr 29, 1999·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·A J MangramW R Jarvis
Sep 22, 2001·Toxicology in Vitro : an International Journal Published in Association with BIBRA·E Hidalgo, C Dominguez
Dec 26, 2002·American Journal of Obstetrics and Gynecology·Michael D MoenInbar Kirson
Feb 27, 2003·Emerging Infectious Diseases·Eli N PerencevichRichard Platt
Feb 8, 2005·American Journal of Obstetrics and Gynecology·Patrick J CulliganJames Snyder
May 4, 2005·The Journal of Bone and Joint Surgery. American Volume·Roger V OstranderMichael E Brage
May 26, 2006·International Wound Journal·David J LeaperAnne Berger
Oct 9, 2008·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Deverick J AndersonDeborah S Yokoe
Oct 25, 2008·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Alicia I HidronUNKNOWN Participating National Healthcare Safety Network Facilities
Nov 22, 2008·The Journal of Hospital Infection·C D Owens, K Stoessel
Aug 5, 2009·The Journal of Bone and Joint Surgery. American Volume·Matthew D SaltzmanJason L Koh
Sep 8, 2009·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Brian R SwensonRobert G Sawyer
Jan 8, 2010·The New England Journal of Medicine·Rabih O DarouicheDavid H Berger
Sep 30, 2010·The British Journal of Surgery·D J Leaper
Oct 26, 2010·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Ingi LeeCraig A Umscheid
Feb 18, 2011·Journal of Women's Health·Ishai LevinBenny Almog
Mar 12, 2011·The Journal of Antimicrobial Chemotherapy·S M McHughH Humphreys
May 24, 2011·American Journal of Surgery·Ibrahim Galal, Khaled El-Hindawy
Jan 10, 2012·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Rosa R Baier, Stefan Gravenstein
Mar 23, 2012·The Journal of Bone and Joint Surgery. American Volume·Jason W SavageMichael H Haak
Oct 24, 2012·Obstetrics and Gynecology·Gulden MenderesHaleh Sangi-Haghpeykar
Feb 6, 2013·American Journal of Infection Control·Juan H MaciasAlejandro E Macias
Apr 25, 2013·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Jonia Amer-AlshiekIshai Levin
Jul 19, 2013·Surgical Infections·Heather YoungConnie S Price
Dec 25, 2013·Journal of the American College of Surgeons·Timo W HakkarainenUNKNOWN Surgical Care and Outcomes Assessment Program Collaborative
Feb 28, 2014·Revista do Colégio Brasileiro de Cirurgiões·Ana Luzia Rodrigues, Maria de Lourdes Pessole Biondo Simões
Mar 29, 2014·The New England Journal of Medicine·Shelley S MagillUNKNOWN Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team

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Citations

Jan 7, 2016·The Bone & Joint Journal·S HellerJ Parvizi
Aug 11, 2016·Surgical Infections·Brad S Oriel, Kamal M F Itani
Jan 26, 2017·The British Journal of Surgery·B M GillespieS Kularatna
Jan 30, 2018·Journal of Perioperative Practice·Sonia BathlaDale Vimalachandran
Mar 28, 2018·Journal of Neurosurgical Sciences·Leonello Tacconi, Paolo Bobicchio
Dec 12, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Joseph LetzelterJacques Hacquebord
Apr 9, 2016·Annals of the Royal College of Surgeons of England·B M Davies, H C Patel
Mar 30, 2017·Neurosurgery·Paul A AndersonMohammed F Shamji
Mar 25, 2020·Global Spine Journal·Kivanc AtesokSteven Theiss
Apr 11, 2015·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·B M Davies, H C Patel
Jan 15, 2020·Global Spine Journal·Ilyas S AleemK Daniel Riew
Aug 7, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Christopher J CrnichTrish M Perl
Aug 2, 2020·Antimicrobial Resistance and Infection Control·Jan A RothAndreas F Widmer
Dec 24, 2018·Global Spine Journal·Nicholas T SpinaBrandon D Lawrence
Mar 7, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Charles E EdmistonDavid Leaper
May 7, 2020·Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses·María Sáenz-JalónJose Couceiro
Nov 9, 2018·BioMed Research International·Davide BlonnaRoberto Rossi
Jan 15, 2021·The Spine Journal : Official Journal of the North American Spine Society·Bertrand DebonoHans D de Boer
Aug 14, 2020·Regulatory Toxicology and Pharmacology : RTP·N B HopfA L Bunge
Aug 14, 2021·Surgical Infections·Dominique M DockeryDioscaris R Garcia

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