Comparison of chlorhexidine–isopropanol with isopropanol skin antisepsis for prevention of surgical-site infection after abdominal surgery
| Autor: | Alexis Ulrich, M.W. Büchler, Markus K. Diener, Julian C. Harnoss, Axel Kramer, Pascal Probst, L Scheerer, C Müller-Lantzsch, Ojan Assadian, Thomas Bruckner |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty medicine.drug_class medicine.medical_treatment 030106 microbiology Antisepsis Preoperative care 2-Propanol 03 medical and health sciences 0302 clinical medicine Antiseptic Risk Factors Laparotomy Abdomen Preoperative Care Humans Surgical Wound Infection Medicine Prospective Studies 030212 general & internal medicine Prospective cohort study Aged business.industry Incidence (epidemiology) Chlorhexidine Bacterial Infections Middle Aged Surgery Clinical trial Elective Surgical Procedures Anti-Infective Agents Local Female business Abdominal surgery medicine.drug |
| Zdroj: | British Journal of Surgery. 105:893-899 |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1002/bjs.10793 |
| Popis: | Background Prevention of surgical-site infection (SSI) has received increasing attention. Clinical trials have focused on the role of skin antisepsis in preventing SSI. The benefit of combining antiseptic chlorhexidine with alcohol has not been compared with alcohol-based skin preparation alone in a prospective controlled clinical trial. Methods Between August and October 2014, patients undergoing abdominal surgery received preoperative skin antisepsis with 70 per cent isopropanol (PA). Those treated between November 2014 and January 2015 received 2 per cent chlorhexidine with 70 per cent isopropanol (CA). The primary endpoint was SSI on postoperative day (POD) 10, which was evaluated using univariable analysis, and a multivariable logistic regression model correcting for known independent risk factors for SSI. The study protocol was published in the German Registry of Clinical Studies (DRKS00011174). Results In total, 500 patients undergoing elective midline laparotomy were included (CA 221, PA 279). The incidence of superficial and deep SSIs was significantly different on POD 10: 14 of 212 (6·6 per cent) among those treated with CA and 32 of 260 (12·3 per cent) in those who received PA (P = 0·038). In the multivariable analysis, skin antisepsis with CA was an independent factor for reduced incidence of SSI on POD 10 (P = 0·034). Conclusion This study showed a benefit of adding chlorhexidine to alcohol for skin antisepsis in reducing early SSI compared with alcohol alone. |
| Databáze: | OpenAIRE |
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