用洗必泰进行术后皮肤消毒对肩关节置换手术后细菌定植的影响:随机对照研究

IF 1.8 Q3 INFECTIOUS DISEASES Infection Prevention in Practice Pub Date : 2024-04-26 DOI:10.1016/j.infpip.2024.100365
Ida Markström , Karin Falk-Brynhildsen , Margareta Bachrack-Lindström , Gunilla Hollman Frisman , Sara Mernelius , Kristofer Bjerså
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引用次数: 0

摘要

背景手术部位感染是对患者安全的重大威胁。肩关节置换术因外来植入物而增加了风险。一般来说,皮肤准备是术前预防性干预的关键,使用洗必泰可对细菌定植产生长期影响。关于术后消毒是否会对术后 48 小时内的细菌定植产生影响,目前还缺乏相关证据。我们的假设是,与使用氯化钠相比,术后使用 5 毫克/毫升氯己定溶于 70% 乙醇中的消毒剂会减少金黄色葡萄球菌、凝固酶阴性葡萄球菌和痤疮杆菌在择期肩部手术后最初 48 小时内在手术伤口周围的细菌定植。结果我们的假设没有得到证实。尽管没有统计学意义,但洗必泰组的临床相关细菌定植率较高。结论我们的研究无法证实,与氯化钠相比,术后使用洗必泰消毒可减少细菌定植。研究结果凸显了 SSI 的复杂性以及循证预防性备皮对确保患者安全的重要性。考虑到研究的局限性,还需要进一步研究,探索和评估不同皮肤清洁解决方案和预防策略在不同手术环境中的有效性。
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Impact of postoperative skin disinfection with chlorhexidine on bacterial colonisation following shoulder arthroplasty surgery: a controlled randomised study

Background

Surgical site infections are a significant threat to patient safety. Shoulder arthroplasty carries an increased risk due to foreign implants. Skin preparation in general is a key preoperative preventive intervention, and the use of chlorhexidine can have a prolonged effect on bacterial colonisation. There is a lack of evidence regarding whether postoperative disinfection has an impact on bacterial colonisation during the first 48 hours after surgery. Our hypothesis was that applying postoperative antiseptic with 5 mg/ml chlorhexidine in 70% ethanol would lead to reduced bacterial colonisation with Staphylococcus aureus, coagulase-negative staphylococcus and Cutibacterium acnes around the surgical wound within the initial 48 hours after elective shoulder surgery, compared with the use of sodium chloride.

Methods

A single-blinded, controlled study was conducted at a county hospital in Sweden. Swabs from the skin were collected four times: at baseline, preoperatively, after the intervention and after 48 hours.

Results

Our hypothesis was not confirmed. Although not statistically significant, the chlorhexidine group had a higher prevalence of bacterial colonisation of clinically relevant bacteria.

Conclusions

Our study could not confirm that postoperative disinfection with chlorhexidine reduces bacterial colonisation compared with sodium chloride. The results highlight the complexity of SSIs and the importance of evidence-based preventive skin preparation to ensure patient safety. Further research is needed, considering the study's limitations, to explore and evaluate the effectiveness of different skin cleansing solutions and preventive strategies in diverse surgical contexts.

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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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