P. Adeppa1, Gandikota Venkata Prakash2, G. Purushotham3, Sumesh Raja Shanmugapandi4, Thandra Nallabothula Chandra Chinna Raju5, M. Akhila6
BACKGROUND
Even the normal skin of healthy humans usually harbours a rich bacterial flora,
which are usually non-pathogenic. But these organisms always have a potential to
cause infection of the surgical site. The aim of surgical site preparation with
antiseptics is to remove microorganisms harbouring the skin surface to a lower
level. Povidine iodine (iodophors) and chlorhexidine are the agents most often
used for pre-operative surgical site antisepsis. In this study, we wanted to
determine the efficacy of pre-operative skin preparation with aqueous povidone
iodine alone and when used in combination with alcoholic chlorhexidine for surgical
site asepsis.
METHODS
This is a cross-sectional study. 200 patients (100 in each group) were considered
for the study who were undergoing clean elective surgery. Pre-operative
preparation of skin in the surgical area was done by the respective antiseptic which
was planned accordingly, after such application, sterile saline swab culture was
taken immediately from the site of incision during surgery. In the cases which
showed growth of organisms, they were isolated from colonies and subjected to
gram staining, coagulase test and antibiotic sensitivity test. The organisms thus
isolated were identified by their morphological and cultural characteristics and
difference in colonization rates were considered as a measure of antiseptic
regimen efficacy.
RESULTS
The results showed that, usage of povidine iodine along with alcoholic
chlorhexidine is more efficacious and showed significant reduction of colonization
rates at the site of incision, in comparison to using povidone iodine alone. Postoperative
wound infections were lower, when povidine iodine is used in
combination with chlorhexidine is used for pre-operative surgical site preparation.
CONCLUSIONS
Pre-operative skin preparation with the chlorhexidine gluconate 2.5 % v/v in 70
% propanol followed by aqueous povidone-iodine solution is an ideal for broad
spectrum asepsis and the post-operative wound infection rate is much lower as
compared to povidone iodine alone.
