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Skin antisepsis

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https://www.readbyqxmd.com/read/28817989/optimal-skin-antiseptic-agents-for-prevention-of-surgical-site-infection-in-cesarean-section-a-meta-analysis-with-trial-sequential-analysis
#1
Huaping Huang, Guirong Li, Haiyan Wang, Mei He
PURPOSE: The best choice of antiseptic agent for skin preparation at cesarean section remains controversial. We performed this meta-analysis to assess whether chlorhexidine (CH)-based skin antisepsis was more effective than povidone iodine (PI)-based antisepsis for prevention of surgical site infection (SSI) after cesarean section. METHODS: PubMed, EMBASE, and the Cochrane Library were systematically searched to identify English publications that compared chlorhexidine gluconate (CH) as a skin preparation agent with PI in cesarean section...
August 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28811083/phenotypic-chlorhexidine-and-triclosan-susceptibility-in-clinical-staphylococcus-aureus-isolates-in-australia
#2
C Hughes, J Ferguson
Antiseptics such as chlorhexidine gluconate and triclosan are widely used in healthcare settings for both skin antisepsis and decolonisation of Staphylococcus aureus. We determined the minimum inhibitory concentration (MIC) of 198 methicillin susceptible and resistant Staphylococcus aureus clinical isolates to both chlorhexidine and triclosan using an agar dilution method. Of these, 10% (19/198) showed a raised MIC to chlorhexidine and 3% (6/198) showed an elevated MIC to triclosan. The multilocus sequence type (MLST) of each isolate was predicted using a binary method, and although ST93-MRSA-IV was the most common, ST22-MRSA-IV was shown to have statistically higher chlorhexidine MIC values compared with non ST22-MRSA-IV isolates (z = -8...
August 12, 2017: Pathology
https://www.readbyqxmd.com/read/28790056/alcoholic-versus-aqueous-chlorhexidine-for-skin-antisepsis-the-avalanche-trial
#3
RANDOMIZED CONTROLLED TRIAL
Daniel Charles, Clare F Heal, Meth Delpachitra, Michael Wohlfahrt, Debbie Kimber, Julie Sullivan, Sheldon Browning, Sabine Saednia, Alexandra Hardy, Jennifer Banks, Petra Buttner
BACKGROUND: Preoperative skin antisepsis is routine practice. We compared alcoholic chlorhexidine with aqueous chlorhexidine for skin antisepsis to prevent surgical site infection after minor skin excisions in general practice. METHODS: We conducted this prospective, multicentre, randomized controlled trial in 4 private general practices in North Queensland, Australia, from October 2015 to August 2016. Consecutive adult patients presenting for minor skin excisions were randomly assigned to undergo preoperative skin antisepsis with 0...
August 8, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28768592/effect-of-hand-lotion-on-the-effectiveness-of-hygienic-hand-antisepsis-implications-for-practicing-hand-hygiene
#4
Helga Paula, Nils-Olaf Hübner, Ojan Assadian, Katja Bransmöller, Romy Baguhl, Harald Löffler, Axel Kramer
BACKGROUND: Skin protection products should be used after washing hands with soap, during breaks, after work, and during leisure time. Aside from their beneficial effects, skin care products may also interact with alcohol-based hand disinfectants by reducing their efficacy. The aim of this study was to investigate the effect of a hand lotion on the effectiveness of hygienic hand antisepsis using an alcohol-based handrub. METHODS: The effect of a protective hand lotion against an isopropyl alcohol-based handrub was investigated in 20 healthy volunteers according to the European standard test procedure EN 1500 in the following combinations: handwashing and application of hand lotion, only application of hand lotion, and no washing and no hand lotion (control), each for 5 minutes or 1 hour before hand antisepsis...
August 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28697103/chlorhexidine-alcohol-compared-with-povidone-iodine-for-preoperative-topical-antisepsis-for-abdominal-hysterectomy
#5
Shitanshu Uppal, Ali Bazzi, R Kevin Reynolds, John Harris, Mark D Pearlman, Darrell A Campbell, Daniel M Morgan
OBJECTIVE: To compare preoperative chlorhexidine-alcohol topical antiseptic agent with povidone-iodine in patients undergoing abdominal hysterectomy for benign indications. METHODS: A retrospective cohort study of patients undergoing abdominal hysterectomy from July 2012 to February 2015 in the Michigan Surgical Quality Collaborative was performed. The primary exposure was the use of chlorhexidine-alcohol or povidone-iodine. The primary outcome was surgical site infection within 30 days...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28601567/impact-of-evidence-based-interventions-on-wound-complications-after-cesarean-delivery
#6
Lorene A Temming, Nandini Raghuraman, Ebony B Carter, Molly J Stout, Roxane M Rampersad, George A Macones, Alison G Cahill, Methodius G Tuuli
BACKGROUND: A number of evidence-based interventions have been proposed to reduce post-cesarean delivery wound complications. Examples of such interventions include appropriate timing of preoperative antibiotics, appropriate choice of skin antisepsis, closure of the subcutaneous layer if subcutaneous depth is ≥2 cm, and subcuticular skin closure with suture rather than staples. However, the collective impact of these measures is unclear. OBJECTIVE: We sought to estimate the impact of a group of evidence-based surgical measures (prophylactic antibiotics administered before skin incision, chlorhexidine-alcohol for skin antisepsis, closure of subcutaneous layer, and subcuticular skin closure with suture) on wound complications after cesarean delivery and to estimate residual risk factors for wound complications...
June 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28599898/a-randomized-open-label-controlled-trial-of-chlorhexidine-alcohol-vs-povidone-iodine-for-cesarean%C3%A2-antisepsis-the-capica-trial
#7
Edward H Springel, Xiao-Yu Wang, Vanessa M Sarfoh, Bradley P Stetzer, Steven A Weight, Brian M Mercer
BACKGROUND: Identification of optimal surgical site antisepsis preparations may reduce cesarean-related surgical site infections. Two recently published investigations examined efficacy of chlorhexidine-alcohol and iodine-alcohol preparations. No previous randomized controlled trial has compared chlorhexidine-alcohol to povidone-iodine aqueous scrub and paint in reduction of cesarean-related surgical site infection. OBJECTIVE: The purpose of the study was to determine if chlorhexidine-alcohol would result in fewer surgical site infections than povidone-iodine when used as skin antisepsis preparation prior to cesarean delivery...
June 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28583892/preoperative-chlorhexidine-versus-povidone-iodine-antisepsis-for-preventing-surgical-site-infection-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#8
REVIEW
Dan Zhang, Xi-Chen Wang, Zeng-Xi Yang, Jian-Xin Gan, Jie-Bin Pan, Lan-Ning Yin
BACKGROUNDS: Updated guidelines for surgical site infections (SSIs) suggested that chlorhexidine (CH) or povidone-iodine (PVI) product was equally appropriate to be applied in preoperative disinfection, but which one was optimal remained ambiguous. Moreover, recent studies reported inconsistent results. Thus, an updated meta-analysis was conducted to clarify the superiority of CH or PVI for prevention of SSIs in clean and clean-contaminated surgery. METHODS: From the inception to November 2016, Pubmed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) which explored preoperative antisepsis schemes (CH or PVI) for prevention of SSIs in clean and clean-contaminated surgery...
June 3, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#9
REVIEW
Jaiben George, Alison K Klika, Carlos A Higuera
Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Chlorhexidine is a widely used antiseptic because of its rapid and persistent action. It is well tolerated and available in different formulations at various concentrations. Chlorhexidine can be used for pre-operative skin cleansing, surgical site preparation, hand antisepsis of the surgical team and intra-articular irrigation of infected joints. The optimal intra-articular concentration of chlorhexidine gluconate in irrigation solution is 2%, to provide a persistent decrease in biofilm formation, though cytotoxicity might be an issue...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28526172/skin-antisepsis-it-s-not-only-what-you-use-it-s-the-way-that-you-use-it
#10
A L Casey, J M Badia, A Higgins, J Korndorffer, C Mantyh, O Mimoz, M Moro
No abstract text is available yet for this article.
July 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28394747/risk-and-protective-factors-associated-with-surgical-infections-among-spine-patients
#11
REVIEW
Alyssa G Blood, Melanie F Sandoval, Evalina Burger, Katherine Halverson-Carpenter
BACKGROUND: The purpose of the study was to identify patient-specific and procedure-specific risk and protective factors associated with post-operative surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL, PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the past 10 years (January 2003-March 2015). The keywords and combinations used in the search included: Spine surgery, post-operative infection, risk factors, orthopedic infections...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28277409/randomized-controlled-trial-of-two-alcohol-based-preparations-for-surgical-site-antisepsis-in-colorectal-surgery
#12
Robyn B Broach, Emily C Paulson, Charles Scott, Najjia N Mahmoud
OBJECTIVE: To compare 2 alcohol-based, dual-action skin preparations for surgical site infection (SSI) prevention in elective colorectal surgery. BACKGROUND: Colorectal surgery is associated with the highest SSI rate among elective surgical procedures. Although evidence indicates that alcohol-based skin preparations are superior in SSI prevention, it is not clear if different alcohol-based preparations are equivalent in clean-contaminated colorectal procedures. METHODS: We performed a blinded, randomized, noninferiority trial comparing iodine povacrylex-alcohol (IPA) and chlorhexidine-alcohol for elective, clean-contaminated colorectal surgery...
March 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28159079/guideline-implementation-hand-hygiene
#13
Judith L Goldberg
Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis...
February 2017: AORN Journal
https://www.readbyqxmd.com/read/28131655/a-return-to-the-basics-nurses-practices-and-knowledge-about-interventional-patient-hygiene-in-critical-care-units
#14
Azza H El-Soussi, Hayam I Asfour
BACKGROUND: The Nursing profession is struggling to return to basic nursing care to maintain patients' safety. "Interventional patient hygiene" (IPH) is a measurement model for reducing the bioburden of both the patient and health care worker, and its components are hand hygiene, oral care, skin care/antisepsis, and catheter site care. OBJECTIVES: To identify the level of nurses' practice and knowledge about interventional patient hygiene and identify barriers for implementing interventional patient hygiene in critical care units...
January 25, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28124850/a-quality-improvement-approach-to-reducing-the-caesarean-section-surgical-site-infection-rate-in-a-regional-hospital
#15
M O'Hanlon, C McKenna, E Carton, D Diviney, M R Costello, L O'Sullivan, J Fitzsimons, L Toland, G Dornikova, R Curran, C McCann, L O'Sullivan, T Doherty, C Crowley, S O'Coigligh
Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol...
September 9, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28121042/economic-case-for-intraoperative-interventions-to-prevent-surgical-site-infection
#16
REVIEW
B M Gillespie, W Chaboyer, A Erichsen-Andersson, R M Hettiarachchi, S Kularatna
BACKGROUND: Surgical-site infection (SSI) occurs in 1-10 per cent of all patients undergoing surgery; rates can be higher depending on the type of surgery. The aim of this review was to establish whether (or not) surgical hand asepsis, intraoperative skin antisepsis and selected surgical dressings are cost-effective in SSI prevention, and to examine the quality of reporting. METHODS: The authors searched MEDLINE via Ovid, CINAHL via EBSCO, Cochrane Central and Scopus databases systematically from 1990 to 2016...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28089672/isopropyl-alcohol-is-as-efficient-as-chlorhexidine-to-prevent-contamination-of-blood-cultures
#17
Jovanna Martínez, Juan H Macías, Virginia Arreguín, Jose A Álvarez, Alejandro E Macías, Juan L Mosqueda-Gómez
BACKGROUND: False-positive blood cultures can lead to unnecessary risks and misuse of antibiotics; to reduce rates of false-positives, it would be useful to determine whether use of an antiseptic with a prolonged effect is required. METHODS: Clinical study of efficacy (blinded and randomized) to compare the rate of blood culture contamination when skin antisepsis was performed with 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl alcohol in 2 hospitals...
April 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/27924201/central-line-associated-bloodstream-infections-in-the-intensive-care-unit-importance-of-the-care-bundle
#18
Aynur Atilla, Zahide Doğanay, Hale Kefeli Çelik, Leman Tomak, Özgür Günal, S Sırrı Kılıç
BACKGROUND: The importance and efficacy of a care bundle for preventing central line-associated bloodstream infections (CLABSIs) and infectious complications related to placing a central venous catheter (CVC) in patients in the intensive care unit (ICU). METHODS: A care bundle was implemented from July 2013 to June 2014 in a medical ICU and surgical ICU. Data were divided into three periods: the prior period (July 2012-June 2013), the intervention period (July 2013-June 2014; first and second periods), and the post-intervention period (July 2014-December 2014; third period)...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27890067/clinical-issues-december-2016
#19
Lisa Spruce, Amber Wood
Head coverings Key words: head cover, bouffant, skull cap, hair, scalp. Skin preps Key words: skin preps, antiseptics, cesarean delivery, surgical site infections, abdomen. Pediatric surgical counts Key words: pediatrics, counts, surgical, retained surgical items, policy. Sterile set up Key words: sterile table, sterile set up, covering, monitoring, contamination. Surgical hand antisepsis Key words: surgical hand rub, application, surgical scrub, scrubbed areas.
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27879993/randomized-clinical-trial-of-preoperative-skin-antisepsis-with-chlorhexidine-gluconate-or-povidone-iodine
#20
RANDOMIZED CONTROLLED TRIAL
H M Park, S-S Han, E C Lee, S D Lee, H M Yoon, B W Eom, S H Kim, K W Ryu, S-J Park, Y W Kim, B Park
BACKGROUND: Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone-iodine. METHODS: Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine...
January 2017: British Journal of Surgery
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