Surgical site infection outcomes of 2 different regimens for preoperative skin antisepsis: single layer with povidone-iodine versus double layer with povidone-iodine/ octenidine dihydrochloride

Yıl 2022, , 47 - 51, 26.03.2022

Veysel Barış Turhan , Ramazan Topcu , Alp Yıldız

https://doi.org/10.18663/tjcl.1025960

Öz

Aim: Surgical site infection (SSI) is a frequent complication following any surgery. SSI still one of the main causes of elongated hospitalization, morbidity, and cost charges despite the development of new techniques, new materials, and new procedures. This study aims to compare the postoperative outcomes concerning single or double-layer or disinfectant application.
Material and Methods: This is a retrospective study aiming to inference the results of 2 different methods of preoperative skin disinfection after Lichtenstein tension-free open hernia repair with prolene mesh. A total of 298 patients enrolled in this study. This is a retrospective study comparing the outcomes of SSI open herniorrhaphy with prolene mesh.
Results: Wound infection has occurred in 13 patients from Group-1 (%6.80) versus 3 patients on Group-2 (%2.80) respectively, which is statistically significantly lower than Group-1(p˂0.05).
Conclusion: As our results showed, we suggest that octenidine dihydrochloride could be considered a powerful alternative to conventional disinfectant solutions, but further investigations with a single application of octenidine dihydrochloride are needed.

Anahtar Kelimeler

Herniorrhaphy, skin preparation, skin antisepsis

Preoperatif cilt antisepsisi için 2 farklı rejimin cerrahi alan enfeksiyon sonuçları: povidon-iyot ile tek katmana karşı povidon-iyot / oktenidin dihidroklorür ile çift katman

Öz

Amaç: Cerrahi alan enfeksiyonu (SSI), herhangi bir ameliyattan sonra sık görülen bir komplikasyondur. SSI, yeni teknikler, yeni malzemeler ve yeni prosedürlerin geliştirilmesine rağmen, uzun süreli hastanede yatış, morbidite ve maliyet ücretlerinin ana nedenlerinden biri olmaya devam etmektedir. Bu çalışma, tek veya çift katmanlı dezenfektan uygulamasına ilişkin postoperatif sonuçları karşılaştırmayı amaçlamaktadır.
Gereç ve Yöntemler: : Bu retrospektif bir çalışmadır. Prolen mesh ile Lichtenstein gerilimsiz açık fıtık onarımı sonrası 2 farklı preoperatif cilt dezenfeksiyon yönteminin sonuçlarını çıkarmayı amaçlayan geriye dönük bir çalışmadır. Bu çalışmaya toplam 298 hasta katılmıştır. Bu, SSI açık herniorafi sonuçlarını prolen mesh ile karşılaştıran retrospektif bir çalışmadır.
Bulgular: Grup-1'de 13 hastada (% 6.80), Grup-2'de ise 3 hastada (% 2.80) yara enfeksiyonu meydana geldi ve bu Grup-1'den istatistiksel olarak anlamlı derecede düşüktü (p˂0.05).
Grup-1'den 1 hasta hariç tüm hastaların yüzeyel yara enfeksiyonu temel antibiyotik tedavisi ile çözüldü. Bu hastada parenteral antibiyoterapi gerektiren yara enfeksiyonu gelişti ve 10 günlük tedaviden sonra çözüldü.
Sonuç: Sonuçlarımızın gösterdiği gibi, oktenidin dihidroklorürün geleneksel dezenfektan solüsyonlarına güçlü bir alternatif olarak düşünülebileceğini, ancak tek bir oktenidin dihidroklorür uygulamasıyla daha ileri araştırmalara ihtiyaç olduğunu öne sürüyoruz.

Anahtar Kelimeler

Herniorrhaphy, cilt hazırlığı, cilt antisepsisi

Kaynakça

• 1. Yasuda T, Hasegawa T, Yamato Y, et al. Optimal Timing of Preoperative Skin Preparation with Povidone-Iodine for Spine Surgery: A Prospective, Randomized Controlled Study. Asian Spine J 2015; 9: 423-26.
• 2. Charehbili A, Swijnenburg RJ, van de Velde C, et al. A retrospective analysis of surgical site infections after chlorhexidine-alcohol versus iodine-alcohol for pre-operative antisepsis. Surg Infect 2014; 15: 310-3.
• 3. Badia JM, Casey AL, Rubio-Pérez I, et al. A survey to identify the breach between evidence and practice in the prevention of surgical infection: Time to take action. Int J Surg 2018; 54: 290-97. 4. Markel TA, Gormley T, Greeley D, et al. Hats off: a study of different operating room headgear assessed by environmental quality indicators, J Am Coll Surg 2017; 225: 573-81
• 5. Zamora JL. Chemical and microbiologic characteristics and toxicity of povidone-iodine solutions. Am J Surg 1986; 151: 400-6.
• 6. Michel D, Zach GA. Antiseptic efficacy of disinfecting solutionsin suspension test in vitro against methicillin-resistantStaphy-lococcus aureus, Pseudomonas aeruginosa and Escherichia coliinpressure sore wounds after spinal cord injury. Dermatol 1997; 195: 36–41
• 7. Goroncy-Bermes P. Investigation of the efficacy of disinfectantsagainst MRSA and vancomycin-resistant enterococci. Zentralbl Hyg Umweltmed 1998; 201: 297–309.
• 8. Harke HP. Octenidine dihydrochloride, properties of a new an-timicrobial agent. Zentralbl Hyg Umweltmed 1989; 188: 188–93
• 9. Badia JM, Rubio-Pérez I, López-Menéndez J, et al. Spanish Observatory of Surgical Infection. The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study. Int J Surg. 2020; 82: 231-9.
• 10. Badia JM, Casey AL, Rubio-P ́erez I, et al. Awareness of practice and comparison with best evidence in surgical site infection prevention in colorectal surgery, Surg Infect 2020; 21: 218–26.
• 11. Allegranzi B, Bischoff P, de Jonge S, et al, WHO Guidelines Development Group. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective, Lancet Infect. Dis 2016;16: 276–87.
• 12. Jolivet S, Lucet JC. Surgical field and skin preparation. Orthop Traumatol Surg Res 2019; 105: 1-6.
• 13. Blonna D, Allizond V, Bellato E, et al. Single versus Double Skin Preparation for Infection Prevention in Proximal Humeral Fracture Surgery. Biomed Res Int 2018; 14; 2018: 8509527.
• 14. Dumville JC, McFarlane E, Edwards P, et al. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database Syst Rev 2015; 2015: 003949.
• 15. Leclair J. A review of antiseptics. Cleansing agents. Todays OR Nurse 1990; 12: 25-8.
• 16. Tubre DJ, Schroeder AD, Estes J, et al. (2018). Surgical site infection: the “Achilles Heel” of all types of abdominal wall hernia reconstruction. Hernia 2018; 22: 1003-13.
• 17. Müller G, Langer J, Siebert J, Kramer A. Residual antimicrobial effect of chlorhexidine digluconate and octenidine dihydrochloride on reconstructed human epidermis. Skin pharmacology and physiology 2014; 27(1): 1-8.
• 18. Dettenkofer M, Wilson C, Gratwohl, A, et al. (2010). Skin disinfection with octenidine dihydrochloride for central venous catheter site care: a double-blind, randomized, controlled trial. Clin Microbiol 2010; 16: 600-6.
• 19. Larson E. APIC guideline for handwashing and hand antisepsis in health-care settings. Am J Infect Control 1995; 23: 251-69.
• 20. Ciftci IH, Esme H, Sahin DA, et al. Effect of octenidine dihydrochloride on viability of protoscoleces in hepatic and pulmonary hydatid diseases. J Natl Med Assoc 2007; 99: 674-7.