Two per cent alcoholic chlorhexidine versus alcoholic five per cent povidone-iodine for the prevention of perineural catheter colonisation: The CHLOVEPI randomised, controlled trial
| Autor: | Hakim Harkouk, Dominique Fletcher, Alain Beauchet, Florence Espinasse, Tristan Thibault-Sogorb, Valeria Martinez, Christine Lawrence |
|---|---|
| Přispěvatelé: | Physiopathologie et Pharmacologie Clinique de la Douleur (LPPD), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Ambroise Paré [AP-HP], Service de Microbiologie et Hygiène [AP-HP Hôpital Raymond Poincaré], Hôpital Raymond Poincaré [AP-HP], We thank the members of the team from the Anaesthesia Department of Groupe Hospitalier Ambroise Par?-Raymond Poincar?. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.drug_class
Antisepsis Critical Care and Intensive Care Medicine law.invention 03 medical and health sciences 0302 clinical medicine Antiseptic Randomized controlled trial 030202 anesthesiology law Staphylococcus epidermidis medicine Central Venous Catheters Humans Adverse effect Povidone-Iodine biology business.industry perineural catheter colonisation Incidence (epidemiology) Chlorhexidine chlorhexidine 030208 emergency & critical care medicine General Medicine biology.organism_classification 3. Good health Colonisation Catheter Anesthesiology and Pain Medicine Anesthesia Anti-Infective Agents Local povidone-iodine-alcohol and skin antisepsis business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology medicine.drug |
| Zdroj: | Anaesthesia Critical Care & Pain Medicine Anaesthesia Critical Care & Pain Medicine, Elsevier Masson, 2021, 40 (1), ⟨10.1016/j.accpm.2020.100790⟩ |
| ISSN: | 2352-5568 |
| Popis: | International audience; Background: Multimodal analgesia, including a regional technique using perineural catheters (PNCs), is recommended for the treatment of moderate-to-severe acute postoperative pain. Perineural catheters are at risk of bacterial colonisation. In this study, we compared the cutaneous antiseptic efficacy of 2% alcoholic chlorhexidine and povidone-iodine-alcohol for preventing the bacterial colonisation of PNCs in orthopaedic surgery. Methods: We performed a randomised, controlled trial, comparing two cutaneous antisepsis strategies, one based on 2% alcoholic chlorhexidine and the other on povidone-iodine-5% alcohol, for placed PNCs before orthopaedic surgery. The primary endpoint was the incidence of catheter bacterial colonisation (threshold > 1000 colony-forming units/ml). The secondary endpoints were the incidence of catheter-related infections and the adverse effects of the antiseptic solutions. Results: From November 2016 to May 2018, we included 113 patients in this study. The use of alcoholic chlorhexidine was associated with a lower incidence of catheter colonisation (15.5% (n = 9) versus 32.7% (n = 18); OR: 0.28 [0.09-0.77], p = 0.01). No catheter-related infections or adverse effects of antiseptic solutions were observed in either group. The risk factors associated with colonisation were a duration of catheter use ≥ 3 days (p = 0.04) and obesity (p = 0.005). The most frequently identified bacterium was Staphylococcus epidermidis. Conclusion: Skin disinfection with 2% alcoholic chlorhexidine decreases bacterial colonisation rates for placed perineural catheters. |
| Databáze: | OpenAIRE |
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