Mears Simon C, Dinah A Feroz, Knight Trevor A, Frassica Frank J, Belkoff Stephen M
International Center for Orthopaedic Advancement, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
Eplasty. 2008 Jul 16;8:e35.
It is important that during preoperative skin preparation surgical site markings are not erased. The effects of 2 common types of skin preparation solutions on surgical site markings were compared.
Fasciocutaneous skin flaps were harvested and 20 random combinations of 3 letters were written on the skin flaps with a black permanent marker. Ten of the 3-letter combinations received Chloraprep (chlorhexidine gluconate, 2% w/v, plus isopropyl alcohol, 70% v/v) and the other 10 received Duraprep (iodine povacrylex [0.7% available iodine] and isopropyl alcohol [74% w/w]), both according to the manufacturer's guidelines. The skin flaps were photographed digitally before and after application of the solutions. The final pictures were assessed subjectively by 10 surgeons and then objectively to determine the change in visibility of the marking on each specimen.
Of the 300 letters in each group, the number of correctly identified letters was 254 (84.7%) in the Chloraprep group and 284 (94.7%) in the Duraprep group. On the basis of the visibility of skin markings, Chloraprep was 21.8 times more likely (95% credible interval, 7.3-86.7) to erase the site markings than was Duraprep.
Skin preparation with Chloraprep erased more surgical site markings than did Duraprep.
术前皮肤准备过程中手术部位标记不被擦除很重要。比较了两种常见皮肤准备溶液对手术部位标记的影响。
切取筋膜皮瓣，用黑色永久性记号笔在皮瓣上随机书写20组由3个字母组成的组合。其中10组3字母组合接受氯己定醇（葡萄糖酸氯己定，2% w/v，加异丙醇，70% v/v）处理，另外10组接受碘伏（聚维酮碘[有效碘0.7%]和异丙醇[74% w/w]）处理，均按照制造商的说明进行。在涂抹溶液前后对皮瓣进行数字拍照。最终照片由10位外科医生进行主观评估，然后进行客观评估以确定每个标本上标记可见度的变化。
每组300个字母中，氯己定醇组正确识别的字母数为254个（84.7%），碘伏组为284个（94.7%）。基于皮肤标记的可见度，氯己定醇擦除手术部位标记的可能性是碘伏的21.8倍（95%可信区间，7.3 - 86.7）。
与碘伏相比，氯己定醇皮肤准备擦除的手术部位标记更多。
