Preoperative skin antisepsis with chlorhexidine gluconate versus povidone-iodine: a prospective analysis of 6959 consecutive spinal surgery patients
| Autor: | Michael Wang, Barth A. Green, Robert M. Starke, George Jimsheleishvili, Glen R. Manzano, Marina Dididze, Kenneth M. Crandall, George M. Ghobrial, Steven Vanni, Allan D. Levi, Howard B. Levene |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class chemistry.chemical_element Antisepsis Iodine Preoperative care Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Antiseptic 030202 anesthesiology Preoperative Care medicine Clinical endpoint Humans Minimally Invasive Surgical Procedures Surgical Wound Infection Prospective Studies Prospective cohort study Povidone-Iodine business.industry Incidence (epidemiology) Incidence Chlorhexidine General Medicine Middle Aged Spinal surgery Spine Surgery Treatment Outcome chemistry Anesthesia Anti-Infective Agents Local Female business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of neurosurgery. Spine. 28(2) |
| ISSN: | 1547-5646 |
| Popis: | OBJECTIVEThe aim of this study was to determine the efficacy of 2 common preoperative surgical skin antiseptic agents, ChloraPrep and Betadine, in the reduction of postoperative surgical site infection (SSI) in spinal surgery procedures.METHODSTwo preoperative surgical skin antiseptic agents—ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol) and Betadine (7.5% povidone-iodine solution)—were prospectively compared across 2 consecutive time periods for all consecutive adult neurosurgical spine patients. The primary end point was the incidence of SSI.RESULTSA total of 6959 consecutive spinal surgery patients were identified from July 1, 2011, through August 31, 2015, with 4495 (64.6%) and 2464 (35.4%) patients treated at facilities 1 and 2, respectively. Sixty-nine (0.992%) SSIs were observed. There was no significant difference in the incidence of infection between patients prepared with Betadine (33 [1.036%] of 3185) and those prepared with ChloraPrep (36 [0.954%] of 3774; p = 0.728). Neither was there a significant difference in the incidence of infection in the patients treated at facility 1 (52 [1.157%] of 4495) versus facility 2 (17 [0.690%] of 2464; p = 0.06). Among the patients with SSI, the most common indication was degenerative disease (48 [69.6%] of 69). Fifty-one (74%) patients with SSI had undergone instrumented fusions in the index operation, and 38 (55%) patients with SSI had undergone revision surgeries. The incidence of SSI for minimally invasive and open surgery was 0.226% (2 of 885 cases) and 1.103% (67 of 6074 cases), respectively.CONCLUSIONSThe choice of either ChloraPrep or Betadine for preoperative skin antisepsis in spinal surgery had no significant impact on the incidence of postoperative SSI. |
| Databáze: | OpenAIRE |
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