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[白内障手术中聚维酮碘消毒后细菌污染的风险]

[Risk of bacterial contamination after povidone-iodine disinfection for cataract surgery].

作者信息

Yanar A, Zbinden R, de Melo M, Trick A J, Kovacs R, Thiel M A

机构信息

Universitäts-Augenklinik Zürich, Zürich.

出版信息

Klin Monbl Augenheilkd. 2006 May;223(5):357-60. doi: 10.1055/s-2006-926558.

Abstract

BACKGROUND

Povidone-iodine alone or in combination with antibiotics is commonly used for presurgical disinfection in cataract surgery. In spite of the use of the combination Povidone-iodine and ofloxacin, the rate of ocular contamination as assessed from surgical knives was reported to be as high as 26 %. The aim of this study was to investigate the efficacy of diluted Povidone-iodine alone for surgical disinfection.

PATIENTS AND METHODS

126 consecutive patients undergoing elective cataract surgery with a conjunctival wound and a scleral tunnel received prior to surgery a disinfection with diluted Povidone-iodine eye drops (Braunol 1:10 diluted = 0.8 % Povidone-iodine, 3 times every 5 min). To assess residual bacteria on the ocular surface after disinfection, the surgical knives for the side ports and the scleral tunnel were cultured in thioglycolate broth.

RESULTS

In 8 out of 126 (6 %) patients the culture from the surgical knives revealed a positive result (89 % coagulase negative Staphylococci). Four of these 8 cases occurred during a single list. All control cultures remained negative.

CONCLUSION

Diluted Povidone-iodine eye drops alone are highly effective for bacterial disinfection when applied properly. The rate of contamination using 0.8 % Povidone-iodine in our series was considerably lower as compared to that of other studies.

摘要

背景

聚维酮碘单独使用或与抗生素联合使用常用于白内障手术的术前消毒。尽管使用了聚维酮碘和氧氟沙星联合制剂,但据报道,通过手术刀评估的眼部污染率高达26%。本研究的目的是调查单独使用稀释聚维酮碘进行手术消毒的效果。

患者与方法

126例接受择期白内障手术且有结膜伤口和巩膜隧道切口的连续患者,术前用稀释的聚维酮碘滴眼液(Braunol 1:10稀释=含0.8%聚维酮碘,每5分钟滴3次)进行消毒。为评估消毒后眼表的残留细菌,对侧切口和巩膜隧道的手术刀在硫乙醇酸盐肉汤中培养。

结果

126例患者中有8例(6%)手术刀培养结果呈阳性(89%为凝固酶阴性葡萄球菌)。这8例中有4例出现在同一批次手术中。所有对照培养均为阴性。

结论

正确使用时,单独使用稀释的聚维酮碘滴眼液对细菌消毒非常有效。在我们的研究系列中,使用0.8%聚维酮碘的污染率与其他研究相比显著更低。

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