Clévenot D, Robert S, Debaene B, Mimoz O
Département d'anesthésie et de réanimation chirurgicale, centre hospitalo-universitaire La Milétrie, BP 577, 86021 Poitiers, France.
Ann Fr Anesth Reanim. 2003 Nov;22(9):787-97. doi: 10.1016/j.annfar.2003.08.001.
To analyze the most pertinent data from the literature concerning the use of an antiseptic solution before the elaboration of invasive procedures such as blood cultures, insertion of peripheral or central intravenous catheters, and arterial or epidural catheters, and to identify, if any, the "ideal" antiseptic or, at least, the most efficient.
Review of the literature. Data collected from the Medline database concerning experimental, clinical and basic research studies published between 1966 and 2003 and a manual research of references of relevant papers.
After a brief historic and pharmacological reminder, the results of experimental and clinical studies are presented. Concerning the clinical studies, they concerned almost exclusively iodine products and chlorhexidine. These comparative studies are classified according to the punction site and the antiseptic solution used.
Even if the in vitro studies favor iodine products, chlorhexidine in alcoholic solution seems more efficient than povidone iodine in aqueous solution in the clinical setting. Several explanations are suggested to understand the in vitro/in vivo discordances. The place of povidone iodine in alcoholic solution, whose performances on the healthy skin are similar to those of alcoholic chlorhexidine, is being in evaluation.
在制定诸如血培养、外周或中心静脉导管插入术以及动脉或硬膜外导管插入术等侵入性操作之前，分析文献中关于使用防腐剂溶液的最相关数据，并确定是否存在“理想”的防腐剂，或者至少是最有效的防腐剂。
文献综述。从Medline数据库收集1966年至2003年间发表的关于实验、临床和基础研究的资料，并对相关论文的参考文献进行人工检索。
在简短回顾历史和药理学知识后，展示了实验和临床研究的结果。关于临床研究，几乎仅涉及碘制品和洗必泰。这些比较研究根据穿刺部位和所使用的防腐剂溶液进行分类。
尽管体外研究倾向于碘制品，但在临床环境中，酒精溶液中的洗必泰似乎比水溶液中的聚维酮碘更有效。针对体外/体内不一致性提出了几种解释。酒精溶液中聚维酮碘在健康皮肤上的表现与酒精洗必泰相似，其地位正在评估中。
