Persson M, Flock J-I, van der Linden J
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institute, Huddinge University Hospital, SE-141 86 Stockholm, Sweden.
J Hosp Infect. 2003 Aug;54(4):294-9. doi: 10.1016/s0195-6701(03)00135-x.
Postoperative wound infections are often a result of peri-operative contamination by Staphylococcus aureus. With a new insufflation device, a gas diffuser, it has become possible to establish a local micro-environment of almost 100% carbon dioxide in an open surgical wound. The device enables ventilation of the wound with an antiseptic agent, which in gaseous form can be delivered as a low uniform dose to all parts of the wound. The use of carbon dioxide (CO2) as a carrier gas eliminates possible inflammability of an antiseptic agent and helps to concentrate it to the site of interest by gravity. Using the above delivery system we have demonstrated the antibacterial effect of gaseous ethanol on S. aureus inoculated on sterile filter disks and blood agar plates, respectively. Ethanol is a very potent antiseptic agent with known properties, which makes it suitable for testing the maximal decontamination level. On filter disks, CO2 carrying vapour from a 95% ethanol solution decreased the number of colony-forming units after 5 min of exposure (P=0.04), and killed all bacteria within 10-15 min (P<0.001). In the presence of organic material, i.e. on exposed blood agar plates, the colony size decreased with exposure time, and no colonies were detected after 60 min of exposure (P<0.001). Antiseptic gas derived from 70% ethanol solution was less effective than that from 95% ethanol (P<0.001). CO2 humidified with water did not have a significant effect on number or size of the colonies. Our findings suggest that intraoperative wound antisepsis with a gas mixture of CO2 and an antiseptic agent delivered with a gas diffuser, may be a simple method to reduce the risk of postoperative wound infection.
术后伤口感染通常是由金黄色葡萄球菌在围手术期污染所致。借助一种新型吹入装置——气体扩散器，在开放性手术伤口中建立几乎100%二氧化碳的局部微环境已成为可能。该装置能使伤口用一种抗菌剂进行通气，这种抗菌剂以气态形式可作为低均匀剂量输送至伤口的所有部位。使用二氧化碳（CO₂）作为载气可消除抗菌剂可能的易燃性，并通过重力作用将其浓缩至感兴趣的部位。利用上述输送系统，我们分别证明了气态乙醇对接种在无菌滤纸片和血琼脂平板上的金黄色葡萄球菌的抗菌作用。乙醇是一种具有已知特性的强效抗菌剂，这使其适合用于测试最大去污水平。在滤纸片上，携带95%乙醇溶液蒸气的CO₂在暴露5分钟后可减少菌落形成单位的数量（P = 0.04），并在10 - 15分钟内杀死所有细菌（P < 0.001）。在存在有机物质的情况下，即在暴露的血琼脂平板上，菌落大小随暴露时间减小，暴露60分钟后未检测到菌落（P < 0.001）。源自70%乙醇溶液的抗菌气体比源自95%乙醇的抗菌气体效果差（P < 0.001）。用水加湿的CO₂对菌落数量或大小没有显著影响。我们的研究结果表明，术中使用气体扩散器输送的CO₂和抗菌剂的气体混合物进行伤口消毒，可能是一种降低术后伤口感染风险的简单方法。
