Veiga Daniela F, Damasceno Carlos A V, Filho Joel Veiga, Silva Rivalino V, Cordeiro Daniel L, Vieira Antonio M, Andrade Carlos H V, Ferreira Lydia M
Pouso Alegre and São Paulo, Brazil From the Divisions of Plastic Surgery and Anesthesiology, Department of Surgery, and the Departments of Microbiology and Medicine, Universidade do Vale do Sapucaí; and the Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo.
Plast Reconstr Surg. 2008 Jan;121(1):115-118. doi: 10.1097/01.prs.0000293861.02825.76.
Preoperative showering with antiseptic skin cleansers is common in elective operations, although the value of this procedure in reducing surgical wound infections has not been established. The authors designed a prospective study to assess the influence of povidone-iodine preoperative showers on skin colonization in elective plastic surgery procedures.
Patients older than 18 years scheduled for elective and clean plastic surgery procedures on the thorax or abdomen were assigned randomly to the povidone-iodine group (n = 57) or to a control group (n = 57). Patients allocated to the povidone-iodine group took a shower with liquid detergent-based povidone-iodine 10% 2 hours before surgery. For the control group, no special instructions for showering were implemented before surgery. Quantitative skin cultures were obtained just before the preoperative scrub in the operating room. Samples were plated on hypertonic mannitol agar, blood agar, Sabouraud agar with chloramphenicol, and eosin-methylene blue agar. Samples were collected and processed, and results were assessed by blinded investigators.
Staphylococcal skin colonization was significantly lower in the povidone-iodine group (p < 0.001). No microorganism growth was observed on 33 percent of the postshower skin cultures from patients in the povidone-iodine shower group compared with 0 percent of the cultures from patients in the control group. Colonies of fungi and enterobacteria were recovered in small amounts in both groups, and povidone-iodine showers did not significantly reduce skin colonization by these microorganisms.
Single preoperative povidone-iodine showers are effective in reducing staphylococcal skin colonization before elective clean plastic surgical procedures on the thorax and abdomen.
在择期手术中，术前使用抗菌皮肤清洁剂进行沐浴很常见，尽管该操作在降低手术伤口感染方面的价值尚未得到证实。作者设计了一项前瞻性研究，以评估术前聚维酮碘沐浴对择期整形手术中皮肤定植的影响。
计划在胸部或腹部进行择期清洁整形手术的18岁以上患者被随机分为聚维酮碘组（n = 57）或对照组（n = 57）。分配到聚维酮碘组的患者在手术前2小时用含10%液体洗涤剂的聚维酮碘沐浴。对于对照组，术前未实施特殊的沐浴指导。在手术室术前刷洗前即刻获取定量皮肤培养物。样本接种于高渗甘露醇琼脂、血琼脂、含氯霉素的沙氏琼脂和伊红美蓝琼脂上。收集并处理样本，由不知情的研究者评估结果。
聚维酮碘组的葡萄球菌皮肤定植显著更低（p < 0.001）。聚维酮碘沐浴组患者沐浴后皮肤培养物中有33%未观察到微生物生长，而对照组患者的培养物中这一比例为0%。两组均少量检出真菌和肠杆菌菌落，聚维酮碘沐浴并未显著减少这些微生物引起的皮肤定植。
术前单次聚维酮碘沐浴可有效减少胸部和腹部择期清洁整形手术前的葡萄球菌皮肤定植。
