Jacobson Cassie, Osmon Douglas R, Hanssen Arlen, Trousdale Robert T, Pagnano Mark W, Pyrek Janine, Berbari Elie, Naessens James
3M Company, St. Paul, MN, USA.
Clin Orthop Relat Res. 2005 Oct;439:32-7. doi: 10.1097/01.blo.0000182245.29830.bc.
The use of the preoperative skin preparation DuraPrep is thought to enhance the adhesion qualities of an incise drape. If there is less drape lift it was hypothesized that there may be a reduction in wound contamination. We did a single-center, randomized trial to determine if a preoperative skin preparation containing DuraPrep solution plus Ioban 2 drapes reduced wound contamination in total joint replacement surgery compared with a povidone iodine scrub and paint plus Ioban 2 drapes. Secondary research questions focused on comparisons of differences in drape lift and cost between the two groups. Of the 176 evaluable patients, the proportion of patients with a contaminated wound was similar in the two groups (DuraPrep 28.0% versus povidone iodine 36.4%). The mean drape lift in the DuraPrep group was less than the povidone iodine group (1.5 cm versus 9.9 cm respectively). The mean cost of prepping was lower for the DuraPrep group compared with the povidone iodine group (dollars 93.36 and dollars 248.91, respectively). A preoperative skin preparation regimen containing DuraPrep solution plus Ioban 2 drapes is equivalent to a povidone iodine scrub and paint and Ioban 2 for the prevention of wound contamination during total joint replacement surgery. Improved drape lift and cost may influence the choice between the two methods.
术前皮肤准备使用DuraPrep被认为可增强切口单巾的粘贴性能。如果单巾掀起较少，据推测伤口污染可能会减少。我们进行了一项单中心随机试验，以确定与聚维酮碘擦洗和涂抹加Ioban 2单巾相比，含DuraPrep溶液加Ioban 2单巾的术前皮肤准备在全关节置换手术中是否能减少伤口污染。次要研究问题集中在两组之间单巾掀起差异和成本的比较上。在176例可评估患者中，两组伤口被污染患者的比例相似（DuraPrep组为28.0%，聚维酮碘组为36.4%）。DuraPrep组的平均单巾掀起高度低于聚维酮碘组（分别为1.5厘米和9.9厘米）。DuraPrep组的术前准备平均成本低于聚维酮碘组（分别为93.36美元和248.91美元）。含DuraPrep溶液加Ioban 2单巾的术前皮肤准备方案在全关节置换手术中预防伤口污染方面等同于聚维酮碘擦洗和涂抹加Ioban 2单巾。单巾掀起情况的改善和成本可能会影响两种方法之间的选择。
