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Skin antisepsis

Elizabeth Story-Roller, Melvin P Weinstein
Blood cultures (BC) are the standard method for diagnosis of bloodstream infections (BSI). However, the average BC contamination rate (CR) in US hospitals is 2.9%, potentially resulting in unnecessary antibiotic use and excessive therapy costs. Several studies have compared various skin antisepsis agents without a clear consensus as to which agent is most effective in reducing contamination. A prospective, randomized crossover study was performed at Robert Wood Johnson University Hospital (RWJUH) directly comparing blood culture contamination rates using chlorhexidine vs...
October 5, 2016: Journal of Clinical Microbiology
G Kampf
Chlorhexidine digluconate (CHG) is an antimicrobial agent used for different types of applications in hand hygiene, skin antisepsis, oral care, and patient washing. Increasing use raises concern regarding development of acquired bacterial resistance. Published data from clinical isolates with CHG minimum inhibitory concentrations (MICs) were reviewed and compared to epidemiological cut-off values to determine resistance. CHG resistance is rarely found in Escherichia coli, Salmonella spp., Staphylococcus aureus or coagulase-negative staphylococci...
August 26, 2016: Journal of Hospital Infection
Gregory Tsoucalas, Konstantinos Laios, Marianna Karamanou, Markos Sgantzos, George Androutsos
Daniel Mollière, was a French anatomist and surgeon, born in Lyon, who succeeded in his short life in making his mark in surgery. He was a prolific writer who left a series of medical treatises and a committed surgeon who was responsible for various significant innovative apparatuses in the medical sper. As he lived in an era when the role of microbe had already been recognized, he was among the first to use antisepsis and install extreme measures against microbes, both in the air and on the skin'. Fountains with fresh clean water, carbonic acid, cross ventilation, medical blouses, combined with Valette's apparatus for the dressing of amputations, were some of his precautions to reduce surgical infections and post-operative mortality...
September 1, 2016: Le Infezioni in Medicina
No abstract text is available yet for this article.
September 2016: AORN Journal
Olivier Mimoz, Vineet Chopra, Andreas Widmer
No abstract text is available yet for this article.
August 11, 2016: Intensive Care Medicine
Cornelia Sigrid Lissi Müller, Barbara Burgard, Monika Zimmerman, Thomas Vogt, Claudia Pföhler
Methods used in the treatment of acute and chronic wounds undergo constant evolution, reevaluation, and innovation. While negative-pressure wound therapy (NPWT) is an established treatment modality, the combination of NPWT and instillation of normal saline as well as solutions with active antiseptic components for topical treatment of the wound bed represents a novel approach. The well-known effects of NPWT may thus be combined with those of local antisepsis. They include a decrease in wound area, induction of granulation tissue, and reduction in bacterial colonization...
August 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Brad S Oriel, Kamal M F Itani
BACKGROUND: Surgical site infections (SSI) remain a significant problem to both the patients and the healthcare system. Value care and standardized quality measures continue to promote improvement in surgical asepsis, but certain debates remain unresolved in the field of surgical hand antisepsis. METHODS: Review of relevant accounts and literature. RESULTS: Controversy has existed regarding the U.S. Food and Drug Administration (FDA)'s 1994 Tentative Final Monograph (TFM), which defined how surgical hand antisepsis products are assessed...
August 10, 2016: Surgical Infections
Nai Ming Lai, Nai An Lai, Elizabeth O'Riordan, Nathorn Chaiyakunapruk, Jacqueline E Taylor, Kenneth Tan
BACKGROUND: The central venous catheter (CVC) is a device used for many functions, including monitoring haemodynamic indicators and administering intravenous medications, fluids, blood products and parenteral nutrition. However, as a foreign object, it is susceptible to colonisation by micro-organisms, which may lead to catheter-related blood stream infection (BSI) and in turn, increased mortality, morbidities and health care costs. OBJECTIVES: To assess the effects of skin antisepsis as part of CVC care for reducing catheter-related BSIs, catheter colonisation, and patient mortality and morbidities...
2016: Cochrane Database of Systematic Reviews
Salma Abbas, Sangeeta Sastry
Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality in the USA. They are associated with a substantial increase in health care costs each year. Fortunately, many HAIs are preventable, and their eradication is a national priority. Chlorhexidine (CHG) bathing has been used as an infection prevention measure, either alone or bundled with other interventions, with mostly beneficial results. The recent surge in its use as an agent of choice for skin antisepsis has lead to concerns over emerging resistance among microorganisms...
August 2016: Current Infectious Disease Reports
C F Heal, D Charles, A Hardy, M Delpachitra, J Banks, M Wohlfahrt, Sabine Saednia, P Buettner
INTRODUCTION: Surgical site infection (SSI) after minor skin excisions has a significant impact on patient morbidity and healthcare resources. Skin antisepsis prior to surgical incision is used to prevent SSI, and is performed routinely worldwide. However, in spite of the routine use of skin antisepsis, there is no consensus regarding which antiseptic agents are most effective. The AVALANCHE trial will compare Aqueous Versus Alcoholic Antisepsis with Chlorhexidine for Skin Excisions. METHODS AND ANALYSIS: The study design is a prospective, randomised controlled trial (RCT) with the aim of investigating the impact of two different antiseptic preparations on the incidence of superficial SSI in patients undergoing minor skin excisions...
2016: BMJ Open
C D Biermann, A Kribs, B Roth, I Tantcheva-Poor
UNLABELLED: Background Nosocomial infections are a serious problem in the treatment of extremely low birth weight infants (ELBW, <1 000 g). In these patients, effective skin antisepsis is critical to prevent hospital-acquired infections and their sequelae. However, serious side effects of topical antiseptics have been repeatedly reported in extremely preterm infants and no agreement has been reached on the best product in this population. Therefore, we conducted a survey of the German NICUs aiming to investigate current practices and safety of topical antiseptics in ELBW neonates...
July 2016: Klinische Pädiatrie
Paolo Frassanito, Luca Massimi, Gianpiero Tamburrini, Mauro Pittiruti, Francesco Doglietto, Carlotta Ginevra Nucci, Massimo Caldarelli
BACKGROUND: Accidental dislocation or removal is a well-known complication of external cerebrospinal fluid (CSF) drainage in daily clinical practice. At present, no data about the incidence of such complications are available in the scientific literature. SecurAcath (Interrad Medical, Plymouth, Minnesota, USA) is a subcutaneously anchored device recently adopted for securement of central venous catheters, known to be highly effective (and cost-effective) in reducing the risk of catheter dislodgement and/or accidental removal...
September 2016: World Neurosurgery
Harun Djozic, Haris Pandza, Sefik Hasukic, Samir Custovic, Berina Pandza, Amina Krupalija, Edin Beciragic
BACKGROUND: The risk of wound infection after elective inguinal hernia repair depends on several factors. One of the most important factors is the preoperative skin preparation. The use of antisepsis is performed to reduce the risk of surgical site infections (SSIs) and to remove causing organisms. This work compares two different agent forms for preoperative skin preparation to prevent SSIs. OBJECTIVES: The objective of the study is comparing the effects of two different agents used for preoperative skin preparation and prevention of SSIs...
April 2016: Medical Archives
William A Rutala, David J Weber
All invasive procedures involve contact by a medical device or surgical instrument with a patient's sterile tissue or mucous membranes. The level of disinfection or sterilization is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection and low-level disinfection, respectively...
May 2, 2016: American Journal of Infection Control
Roser Santacatalina Mas, Ma Teresa Peix Sagues, Josep Miranda Salmerón, Marta Claramunt Jofre, Alba López López, Elena Salas Marco
The importance of protocols for preoperative antisepsis of the hands is given by the risk of transferring bacteria from the hands of the surgical team to the patient during surgery and it is relationship with infection of surgical wound site (SSI). Careful surgical scrub reduces the number of bacteria on the skin, but does not eliminate them completely, remaining transient microorganisms on hands after the surgical scrub. There fore if micropuncture in surgical gloves occurs, the correct preoperative preparation of hands and double gloving will be essential to reduce the risk of bacterial transmission to patients...
February 2016: Revista de Enfermería
B M Davies, H C Patel
Introduction Surgical site infection (SSI) is a significant cause of postoperative morbidity and mortality. Effective preoperative antisepsis is a recognised prophylactic, with commonly used agents including chlorhexidine (CHG) and povidone-iodine (PVI). However, there is emerging evidence to suggest an additional benefit when they are used in combination. Methods We analysed data from our prospective SSI database on patients undergoing clean cranial neurosurgery between October 2011 and April 2014. We compared the case-mix adjusted odds of developing a SSI in patients undergoing skin preparation with CGH or PVI alone or in combination...
July 2016: Annals of the Royal College of Surgeons of England
C O'Connor, R K Philip, J Powell, B Slevin, C Quinn, L Power, N H O'Connell, C P Dunne
Contaminated blood cultures represent challenges regarding diagnosis, duration of hospitalization, antimicrobial use, pharmacy and laboratory costs. Facing problematic neonatal blood culture contamination (3.8%), we instigated a successful intervention combining skin antisepsis using sterile applicators with 2% chlorhexidine gluconate in 70% isopropanol prior to phlebotomy (replacing 70% isopropanol) and staff education. In the six months prior to intervention, 364 neonatal peripheral blood samples were collected...
May 2016: Journal of Hospital Infection
Olivier Mimoz, Vineet Chopra, Jean-François Timsit
No abstract text is available yet for this article.
February 3, 2016: Intensive Care Medicine
Methodius G Tuuli, Jingxia Liu, Molly J Stout, Shannon Martin, Alison G Cahill, Anthony O Odibo, Graham A Colditz, George A Macones
BACKGROUND: Preoperative skin antisepsis has the potential to decrease the risk of surgical-site infection. However, evidence is limited to guide the choice of antiseptic agent at cesarean delivery, which is the most common major surgical procedure among women in the United States. METHODS: In this single-center, randomized, controlled trial, we evaluated whether the use of chlorhexidine-alcohol for preoperative skin antisepsis was superior to the use of iodine-alcohol for the prevention of surgical-site infection after cesarean delivery...
February 18, 2016: New England Journal of Medicine
Eduardo Almeida da Silveira, Kirstin A Bubeck, Edisleidy Rodriguez Batista, Perrine Piat, Sheila Laverty, Guy Beauchamp, Marie Archambault, Yvonne Elce
This prospective clinical study evaluates the effectiveness of an alcohol-based hand rub (Avagard™) for pre-surgical hand antisepsis in an equine hospital and compares it with traditional scrubbing technique using 4% chlorhexidine gluconate sponges and water. Prior to elective surgery, 3 board-certified surgeons were randomly assigned to hand antisepsis with either technique. Culture samples of each hand were taken at 4 times: before and after neutral soap hand wash, after scrub or rubbing technique, and after surgery...
February 2016: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
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