The Efficacy of Pre - Disinfection Skin Scrub With 4% Chlorhexidine Gluconate in Preventing Surgical Site Infections for Patients With Hepatectomy
Surgical site infections (SSIs) following elective surgical procedures occur most commonly
as a result of colonization by the patient's native skin flora . The most common pathogens
causing SSIs are Staphylococcus aureus and coagulase-negative Staphylococci , components of
normal skin flora . Therefore, preoperative disinfection of the surgical site with an
antiseptic skin preparation is standard practice before any surgical intervention to
decrease skin microbial counts before incision . It is considered an important step in
limiting surgical wound contamination and preventing infection.
A variety of skin-preparation agents and methods are available for preventing surgical site
infections and the techniques for preoperative cleansing of the skin vary among hospitals
and surgeons. There is a pressing need to elucidate the effect of cutaneous disinfection
with chlorhexidine gluconate ( CHG ) in prevention of surgical site infections.
Many studies demonstrated that comparisons with cutaneous disinfection with povidone-iodine,
disinfection with CHG before insertion of an intravascular device and for post-infection
site care can substantially reduce the incidence of device-related infection .
Hence, this study aimed to test whether an additional chlorhexidine gluconate scrub followed
by a routine disinfection would lower the incidence of surgical site culture and subsequent
infection after hepatic resection. This data will show the originality and clinical
importance of a cutaneous pre-disinfection scrubbing solution for such risk patients with
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
the positive rate of the baseline culture , the preoperative culture , and the postoperative culture
Before surgical preparation while the patient was on the table in the operating room , we obtained the first set of aerobic culture from the predefined incision site as the baseline culture. After skin scrubbing and disinfection , we obtained the second set of aerobic culture from the predefined incision site as the preoperative culture. After closure of the wound , we obtained the third set of aerobic culture from the surgical site as the postoperative culture. The result of culture was positive if bacteria were cultured from either stage of the surgical site sampling. We compared the efficacy for eradicating aerobic bacterial pathogens ( reduction of positive culture )from the abdomen between the chlorhexidine gluconate scrubbing group and normal saline scrubbing group .
within 30 days after the operation
YaoLi Chen, MD
Changhua Christian Hospital
Taiwan: Department of Health
CCH - 110801