Presurgical cleansing of the operative area and the hands of the surgical team makes an important contribution in preventing surgical wound infections. In plastic and reconstructive surgery, because of the continuous contamination of the surgical site by the patient's normal flora intraoperatively and postoperatively, the agents should be convenient for use in various parts of the body, and the residual effect of the agents should supply a protection for a long period of time, not only in the surgical area but also on the hands of the surgical team. This prospective study included the surgeons and the nurses of the first two operations of the day in two different operating rooms, examining a total of 598 operations, and 2180 medical personnel, and 36,624 cultures. There were ten study groups, each composed of 218 subjects. Cultures were taken at six steps from three areas. It was found that with the conventional brush scrub technique there was no significant difference between 5 and 10 min of scrubbing. Benzalkonium chloride was as effective as povidone iodine if the scrubbing type and time were not considered. In our study the antiseptic agent was not rinsed with tap water and was left on the skin. Even after drying with a sterile towel the agent was still on the skin as a layer. Regardless of the duration of the technique, the microbial counts after removing the gloves postoperatively were as low as those preoperatively after scrubbing. When compared with the conventional scrub technique, this had a residual effect of very long duration. The postoperative samples taken from the fingernails showed that this technique was capable of disinfecting the subungual area because the agent was still present over the skin as a white lather layer and was covering in the intended regions of the hand
European Journal of Plastic Surgery – Springer Journals
Published: Feb 12, 2003
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