Therefore, allowing 10 minutes drying time after povidone-iodine painting of the surgical field is a simple step in preoperative skin preparation that may reduce the rate of SSI, thus resulting in reducing length of the hospital stay and costs incurred by the patient. We evaluated the effectiveness of two techniques of skin preparation with povidone-iodine. Because bacteria on the skin appeared significantly reduced by allowing povidone-iodine to dry for 10 minutes prior to surgery, we recommend this approach to reduce the incidence of postoperative infections.
Conflict of Interest: No potential conflict of interest relevant to this article was reported. National Center for Biotechnology Information , U. Journal List Asian Spine J v. Asian Spine J. Published online Jun 8. Find articles by Tatsuya Yasuda. Find articles by Tomohiko Hasegawa. Find articles by Yu Yamato. Find articles by Sho Kobayashi. Find articles by Daisuke Togawa. Find articles by Hideyuki Arima.
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Corresponding author: Tatsuya Yasuda. This article has been cited by other articles in PMC. Abstract Study Design A prospective, randomized, controlled study. Purpose The objective of this study was to evaluate the effectiveness of two techniques of skin preparation with povidone-iodine. Overview of Literature Preoperative skin preparation is important for preventing surgical site infection by reducing the bacteria in the surgical area.
Methods Eighty-nine spine surgery patients were randomly allocated to two groups. Results The rate of positive culture was Conclusions Because bacteria on the skin appeared significantly reduced by allowing povidone-iodine to dry for several minutes prior to surgery, we recommend this approach to reduce the incidence of postoperative infections.
Keywords: Surgical wound, Infection, Povidone-iodine. Introduction Surgical site infection SSI is a common complication after spinal surgery.
Materials and Methods In this prospective study, 89 consecutive patients scheduled for spinal surgery between March and September, were randomly allocated to 2 groups according to the patient identification numbers with their consent. Table 1 Patient demographics in each group. Open in a separate window. Results The positive culture rate was Table 2 Culture results. Table 3 Bacterial species. Discussion SSI following adult spinal surgery is a common complication that has been reported to occur in 0.
The p-value thus provides a more intuitive feel of the degree of difference between the two quantities being compared. For our case, the null hypothesis is that the number of surviving bacteria colonies remaining is equal for the two processes that we compare, namely, aerosolized foam and sponge based applicator.
For the control no disinfectant applied , this number starts at CFU and increases over 24 and 48 hours. All bacteria are eliminated no colonies are seen after 24 or 48 hrs of incubation, post-treatment. Viable bacterial count for different bacteria tested on agar plates. Figure 5 show the results of the tests conducted on porcine skin subjected to the same preoperative skin preparation disinfection techniques tested against the same set of bacteria.
In this case, different disinfection protocols have different outcomes. It is noteworthy that as expected for a positive control , the flood coverage with liquid Betadine is able to completely eliminate all bacteria present in this case as well. For the applicator sponge currently used method for pre-operative skin disinfection , none of the bacteria tested were completely eliminated, although in 2 of the 3 cases S. With the foaming betadine suspension new product being investigated , the results obtained did not show statistically significant difference when compared to the sponge-applicator for all the bacteria tested.
The p-values obtained when comparing corresponding readings same bacteria, same duration of incubation are shown in Table 1. Viable bacterial count for different bacteria tested on porcine skin.
When the experiment was repeated by flood coverage of the plates with 1X PBS it was observed that the plates showed bacterial growth similar to that of the control samples for both the substrates. For agar plates as a substrate, the aerosolized foam, like the other existing methods of application, has a very strong bactericidal effect, as observed from the lack of colonies even after 48 hours for all the disinfection methods examined.
Given that these plates provide a smooth surface for the antimicrobial agents to come into contact with the bacteria, it can be considered as an ideal case. Porcine skin can be considered as a more realistic model for studying human skin in-vitro.
Here, the bactericidal effect of the agents tested is mitigated by pores, folds and other structures in the skin that prevent the antimicrobial agents from sustained contact with the bacteria. It may be noted that none of the current surgical site preparation practices can completely sterilize skin. Further, this is a preliminary study that merely looks at the efficacy of the foam against three bacterial species in-vitro, and it only suggests that the foam can be used for surgical site preparation.
This study shows that using a new delivery system aerosolized foam for an established antiseptic betadine achieved bactericidal results comparable to a traditional system that is currently used when tested in-vitro on both agar plates and porcine skin. Given the limitations of this preliminary study, further studies venturing into clinical trials will be needed to obtain substantial evidence for SSI prevention using this product. Skin preparation for preventing infection following caesarean section.
Cochrane Database Syst Rev. PubMed Google Scholar. Prevalence of healthcare-associated infections in acute care hospitals in Jacksonville, Florida. Google Scholar. Systematic review and cost analysis comparing use of chlorhexidine with use of iodine for preoperative skin antisepsis to prevent surgical site infection. Infect Control Hosp Epidemiol.
Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. Estimating health care-associated infections and deaths in U. Public Health Rep. Awad SS. Adherence to surgical care improvement project measures and post-operative surgical site infections. Surg Infect. Article Google Scholar. Guideline for prevention of surgical site infection, Am J Infect Control.
Povidone iodine gel alcohol: a second, onetime application preoperative skin preparation. Hemani ML, Lepor H. Skin preparation for the prevention of surgical site infection: which agent is best?
Rev Urol. Paint-only is equivalent to scrub-and-paint in preoperative preparation of abdominal surgery sites. Single use only. Single use may prevent extrinsic contamination Wet skin with water Apply scrub 1 mL is sufficient to cover an area of square inches ; develop lather and scrub thoroughly for about 5 minutes Rinse off using sterile gauze saturated with water The area may then be painted with Betadine solution and allowed to dry. Other Products. Learn more. For Professional and Hospital Use only.
Not Labeled for Consumer Use. Single use will reduce the risk of infection from extrinsic contamination with products not labeled as single use only. Do not use in the eyes or if you are allergic to povidone-iodine or any other ingredients in this preparation. Stop use and ask a doctor if irritation, sensitization, or allergic reaction occurs.
When using these products, prolonged exposure to wet solution may cause irritation or, rarely, severe skin reactions. Povidone iodine topical is available in many different forms, such as a liquid, ointment, aerosol powder, cream, spray, swab, and soap. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. Always follow directions on the medicine label about using this medicine on a child.
Some forms of povidone iodine topical should not be used in children of certain ages. Povidone iodine topical is usually applied to the skin as needed. First clean the area to be treated. Allow the medicine to dry completely on the skin before applying a bandage. Do not apply a tight bandage. Do not use this medicine on deep wounds, puncture wounds, animal bites, or serious burns. Do not apply over large skin areas. When treating an infection, you may be given antibiotic medication to take by mouth.
Use all medicines for the full prescribed length of time, even if your symptoms quickly improve. Povidone iodine topical used in the mouth may be used up to 4 times per day.
How often you can use this medicine depends on what form you use. Follow all directions on the medicine label. Do not use povidone iodine topical in the mouth if you are using a form that is made for use only on the skin.
To use povidone iodine topical spray in the mouth, spray directly into the mouth or throat.
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