Veterinary surgery : VS · 2024
Influence of skin preparation on surgical site infection and lift of adhesive surgical drapes.
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Gant James W, Collins Josh E, Miller Zachary A, Einsporn Richard L
Аннотация
OBJECTIVE: To determine the influence on surgical site infection (SSI) rates when using 0.7% iodophor and 74% isopropyl alcohol versus 2% chlorhexidine and 70% isopropyl alcohol. To evaluate the adherence of an iodophor-impregnated surgical incise drape when used in conjunction with 0.7% iodophor and 74% isopropyl alcohol.
STUDY DESIGN: Combines retrospective control and prospective data.
SAMPLE POPULATION: This study included dogs and cats, 653 retrospective cases and 435 prospective cases, with 447 incisions.
METHODS: The SSI rate of a 2% chlorhexidine and 70% isopropyl alcohol preparation was retrospectively reviewed. The prospective population received 0.7% iodophor and 74% isopropyl alcohol; risk factors for SSI were evaluated and incise drape lift was documented.
RESULTS: A 1.8% difference in SSI between the chlorhexidine group and 0.7% iodophor and 74% isopropyl alcohol group was found (p = .25). The drape lift was 13.2%. Drape lift (p = .026), increased body weight (p = .008), and the use of glutaraldehyde for instrument sterilization (p = .055) were associated with an increased risk of SSI development.
CONCLUSION: The 0.7% iodophor and 74% isopropyl alcohol treatments demonstrated similar effectiveness to 2% chlorhexidine and 70% isopropyl alcohol in skin preparation. Using an iodophor-impregnated drape with 0.7% iodophor and 74% isopropyl alcohol reduced both drape lift and the risk of SSI.
CLINICAL SIGNIFICANCE: These findings support the combined use of an incise drape with 0.7% iodophor and 74% isopropyl alcohol preparation, provide evidence against the use of glutaraldehyde, and indicate that heavier patients have an increased risk of SSI.
STUDY DESIGN: Combines retrospective control and prospective data.
SAMPLE POPULATION: This study included dogs and cats, 653 retrospective cases and 435 prospective cases, with 447 incisions.
METHODS: The SSI rate of a 2% chlorhexidine and 70% isopropyl alcohol preparation was retrospectively reviewed. The prospective population received 0.7% iodophor and 74% isopropyl alcohol; risk factors for SSI were evaluated and incise drape lift was documented.
RESULTS: A 1.8% difference in SSI between the chlorhexidine group and 0.7% iodophor and 74% isopropyl alcohol group was found (p = .25). The drape lift was 13.2%. Drape lift (p = .026), increased body weight (p = .008), and the use of glutaraldehyde for instrument sterilization (p = .055) were associated with an increased risk of SSI development.
CONCLUSION: The 0.7% iodophor and 74% isopropyl alcohol treatments demonstrated similar effectiveness to 2% chlorhexidine and 70% isopropyl alcohol in skin preparation. Using an iodophor-impregnated drape with 0.7% iodophor and 74% isopropyl alcohol reduced both drape lift and the risk of SSI.
CLINICAL SIGNIFICANCE: These findings support the combined use of an incise drape with 0.7% iodophor and 74% isopropyl alcohol preparation, provide evidence against the use of glutaraldehyde, and indicate that heavier patients have an increased risk of SSI.