TITLE

Efficacy of Surgical Preparation Solutions in Shoulder Surgery

AUTHOR(S)
Saltzman, Matthew D.; Nuber, Gordon W.; Gryzlo, Stephen M.; Marecek, Geoffrey S.; Koh, Jason L.
PUB. DATE
August 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;Aug2009, Vol. 91-A Issue 8, p1949
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Deep infection following shoulder surgery is a rare but devastating problem. The use of an effective skin-preparation solution may be an important step in preventing infection. The purposes of the present study were to examine the native bacteria around the shoulder and to determine the efficacy of three different surgical skin- preparation solutions on the eradication of bacteria from the shoulder. Methods: A prospective study was undertaken to evaluate 150 consecutive patients undergoing shoulder surgery at one institution. Each shoulder was prepared with one of three randomly selected solutions: ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol), DuraPrep (0.7% iodophor and 74% isopropyl alcohol), or povidone-iodine scrub and paint (0.75% iodine scrub and 1.0% iodine paint). Aerobic and anaerobic cultures were obtained prior to skin preparation for the first twenty patients, to determine the native bacteria around the shoulder, and following skin preparation for all patients. Results: Coagulase-negative Staphylococcus and Propionibacterium acnes were the most commonly isolated organisms prior to skin preparation. The overall rate of positive cultures was 31% in the povidone-iodine group, 19% in the DuraPrep group, and 7% in the ChloraPrep group. The positive culture rate for the ChloraPrep group was lower than that for the povidone-iodine group (p < 0.0001) and the DuraPrep group (p = 0.01). ChloraPrep and DuraPrep were more effective than povidone-iodine in eliminating coagulase-negative Staphylococcus from the shoulder region (p < 0.001 for both). No significant difference was detected among the agents in their ability to eliminate Propionibacterium acnes from the shoulder region. No infections occurred in any of the patients treated in this study at a minimum of ten months of follow-up. Conclusions: ChloraPrep is more effective than DuraPrep and povidone-iodine at eliminating overall bacteria from the shoulder region. Both ChloraPrep and DuraPrep are more effective than povidone-iodine at eliminating coagulase-negative Staphylococcus from the shoulder. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
43637148

 

Related Articles

  • Evolution of the Imaging Tests in Hemophilia with Emphasis on Radiography and Magnetic Resonance Imaging. Kilcoyne, R. F.; Lundin, B.; Pettersson, H. // Acta Radiologica;Apr2006, Vol. 47 Issue 3, p287 

    Even before the discovery of X-rays in 1895 attempts were being made to classify the joint destruction that occurs in hemophilic arthropathy. The advent of radiography added impetus to the search for the optimum classification system. Subsequent attempts have included advanced imaging methods,...

  • Mycoplasma hominis brain abscess following uterus curettage: a case report.  // Journal of Medical Case Reports;2011, Vol. 5 Issue 1, p1 

    The article presents a case study of a 41-year-old Caucasian woman with mycoplasma hominis brain abscess following uterus curettage. A computed tomography (CT) scan and magnetic resonance imaging (MRI) scan of the brain, identifies a right fronto-parietal hematoma . It mentions that mycoplasma...

  • Percutaneous Curettage and Continuous Irrigation for MRSA Lumbar Spondylodiscitis: A Report of Three Cases. Yamagami, Yoshiki; Shibuya, Sei; Komatsubara, Satoshi; Yamamoto, Tetsuji; Arima, Nobuo // Case Reports in Medicine;2009, p1 

    There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an...

  • Evaluation of the Extracardiac Conduit Modification of the Fontan Operation for Thrombus Formation using Magnetic Resonance Imaging Takawira, Farirai; Ayer, Julian G.; Onikul, Ella; Hawker, Richard E.; Kemp, Allan; Nicholson, Ian A.; Sholler, Gary F. // Heart, Lung & Circulation;Oct2008, Vol. 17 Issue 5, p407 

    Background: The prevalence of thrombosis after the Fontan procedure depends upon the surgical technique used and the method of detection employed. Current investigations for thrombosis lack sensitivity and specificity or, in the paediatric population, require a general anaesthetic....

  • Discrimination between red blood cell and platelet components of blood clots by MR microscopy. Vidmar, Jernej; Serša, Igor; Kralj, Eduard; Tratar, Gregor; Blinc, Aleš // European Biophysics Journal;Sep2008, Vol. 37 Issue 7, p1235 

    Magnetic resonance imaging (MRI) of pulmonary emboli obtained ex vivo, verified by immunohistochemistry, showed that platelet layers display brighter signal intensity than areas containing predominantly red blood cells (RBC) in T 1-weighted MRI. These results were surprising since platelets do...

  • The Kasabach-Merritt Syndrome: Severe Bleeding Disorder Caused by Celiac Arteriography--Reversal by Heparin Treatment. Mewes, Thorsten; Moldenhauer, Helmut; Pfeifer, Joachim; Papenberg, Joachim // American Journal of Gastroenterology;Aug1989, Vol. 84 Issue 8, p965 

    Studies are presented on a 62-yr-old woman with extreme hepatomegaly due to a giant hemangioma with alterations in the clotting system indicating a consumption coagulopathy. There was a fall of hemoglobin, fibrinogen, antithrombin III, and platelet number after arteriography of the truncus...

  • Kasabach Merrit Syndrome in a Third Trimester Pregnancy. Shukla, Samarath; Acharya, Neema; Acharya, Sourya; Rajput, D. P.; Vagha, S. // Journal of Medicine;Jan2011, Vol. 12 Issue 1, p66 

    The case report deals with a third trimester pregnant female who presented with a mass in the dorsal paraspinal region (D7) resulting in rapid onset paraparesis gradually increasing in severity. The mass was of vascular nature (Haemangioma) on MRI, which on histopathology was confirmed as...

  • Bilateral intracranial and spinal subdural hematoma presenting as bilateral sciatica. Jibu, K. J.; Pranesh, M. B.; Prakash, B.; Saifudheen, K. // Journal of Neurosciences in Rural Practice;Jan-Apr2012, Vol. 3 Issue 1, p97 

    The article presents a case study of a 73-year-old man with bilateral intracranial and spinal subdural hematoma which have been perceived as bilateral sciatica. It notes that the absence of vascular abnormality and blood coagulation disorders has been identified through magnetic resonance...

  • Use of MRI for risk stratification in anticoagulation decision making in atrial fibrillation: promising, but more data are needed for a robust algorithm. Wilson, Duncan; Charidimou, Andreas; Werring, David J. // Frontiers in Neurology;Jan2014, Vol. 4, p1 

    A commentary on the article "MRI Screening for Chronic Anticoagulation in Atrial Fibrillation" by M. Fisher et al. is presented. The commentary addresses the difficult decision-making facing stroke physicians and neurologists concerning chronic anticoagulation for atrial fibrillation (AF). Other...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics