Impact of postoperative skin disinfection with chlorhexidine on bacterial colonisation following shoulder arthroplasty surgery: a controlled randomised study.
| Title: | Impact of postoperative skin disinfection with chlorhexidine on bacterial colonisation following shoulder arthroplasty surgery: a controlled randomised study. |
|---|---|
| Authors: | Markström I; Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health, Linköping University, Linköping, Sweden.; Department of Anaesthesiology and Intensive Care, Vrinnevi Hospital, Norrköping, Sweden.; Falk-Brynhildsen K; Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.; Bachrack-Lindström M; Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health, Linköping University, Linköping, Sweden.; Hollman Frisman G; Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health, Linköping University, Linköping, Sweden.; Mernelius S; Laboratory Medicine, Region Jönköping County, Jönköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.; Bjerså K; Department of Surgery, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. |
| Source: | Infection prevention in practice [Infect Prev Pract] 2024 Apr 26; Vol. 6 (2), pp. 100365. Date of Electronic Publication: 2024 Apr 26 (Print Publication: 2024). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101777928 Publication Model: eCollection Cited Medium: Internet ISSN: 2590-0889 (Electronic) Linking ISSN: 25900889 NLM ISO Abbreviation: Infect Prev Pract Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [London] : Elsevier Ltd., [2019]- |
| Abstract: | 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.; (© 2024 The Authors.) |
| References: | J Shoulder Elbow Surg. 2012 Nov;21(11):1534-41. (PMID: 22516570); J Hosp Infect. 2013 Jun;84(2):151-8. (PMID: 23623487); J Bone Joint Surg Am. 2014 Sep 3;96(17):1447-50. (PMID: 25187583); Am J Infect Control. 2012 May;40(4):384-6. (PMID: 21868132); Infect Control Hosp Epidemiol. 2011 Feb;32(2):101-14. (PMID: 21460463); J Hosp Infect. 2017 May;96(1):1-15. (PMID: 28410761); Clin Plast Surg. 1998 Jul;25(3):321-40. (PMID: 9696896); Nepal J Epidemiol. 2020 Sep 30;10(3):878-887. (PMID: 33042591); Surg Infect (Larchmt). 2017 Aug/Sep;18(6):722-735. (PMID: 28832271); Antimicrob Resist Infect Control. 2015 Nov 03;4:44. (PMID: 26539295); Cochrane Database Syst Rev. 2015 Sep 03;(9):CD010259. (PMID: 26331392); Scand J Rheumatol. 2006 Nov-Dec;35(6):426-34. (PMID: 17343249); J Shoulder Elbow Surg. 2018 Sep;27(9):1539-1544. (PMID: 30054245); Am J Infect Control. 2010 Nov;38(9):711-7. (PMID: 21034980); J Antimicrob Chemother. 2012 Nov;67(11):2547-59. (PMID: 22833635); Anaesth Intensive Care. 2008 Jul;36(4):502-12. (PMID: 18714617); J Bone Jt Infect. 2021 Dec 17;6(9):451-456. (PMID: 35024297); J Infect. 2020 Apr;80(4):426-436. (PMID: 31981635); Lancet Infect Dis. 2016 Dec;16(12):e276-e287. (PMID: 27816413); APMIS. 2014 Oct;122(10):961-7. (PMID: 24628476); Surg Infect (Larchmt). 2011 Dec;12(6):497-500. (PMID: 22142318); JAMA Surg. 2017 Aug 01;152(8):784-791. (PMID: 28467526); N Engl J Med. 2004 Apr 1;350(14):1422-9. (PMID: 15070792); J Bone Joint Surg Am. 2016 Oct 19;98(20):1722-1728. (PMID: 27869623); JAMA Intern Med. 2013 Dec 9-23;173(22):2039-46. (PMID: 23999949); J Am Acad Orthop Surg. 2011 Apr;19(4):208-18. (PMID: 21464214); Clin Orthop Relat Res. 2001 Jan;(382):206-16. (PMID: 11153989); J Hosp Infect. 2008 Nov;70 Suppl 2:3-10. (PMID: 19022115); J Bone Joint Surg Am. 2009 Aug;91(8):1949-53. (PMID: 19651954); J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):897-902. (PMID: 19362854); J Shoulder Elbow Surg. 2018 Jul;27(7):1333-1341. (PMID: 29444755); J Shoulder Elbow Surg. 2015 May;24(5):741-6. (PMID: 25595360); J Bone Joint Surg Am. 2013 Dec 4;95(23):e1811-7. (PMID: 24306704); Acta Orthop. 2017 Dec;88(6):592-599. (PMID: 28880117); J Hosp Infect. 1991 Mar;17(3):217-22. (PMID: 1675650); JAMA. 2023 Jan 17;329(3):244-252. (PMID: 36648463); J Shoulder Elbow Surg. 2021 Jun;30(6):1316-1323. (PMID: 33545336) |
| Contributed Indexing: | Keywords: Evidence-based practice; Infection control; Patient safety; Prevention; Skin preparation; Surgical site infections |
| Entry Date(s): | Date Created: 20240520 Latest Revision: 20240521 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11098957 |
| DOI: | 10.1016/j.infpip.2024.100365 |
| PMID: | 38765917 |
| Database: | MEDLINE |
Journal Article