Bourel Clara, Buczinski Sébastien, Desrochers André, Harvey Denis
Faculté de Médecine Vétérinaire, Département des sciences cliniques, Université de Montréal, Saint-Hyacinthe, Quebec, Canada J2S 7C6.
Vet Surg. 2013 Feb;42(2):223-8. doi: 10.1111/j.1532-950X.2013.01089.x. Epub 2013 Feb 1.
To compare 2 preoperative surgical site protocols for standing laparotomy in cattle in a field setting.
Cohort study.
Dairy cows (n = 73) undergoing a clean standing laparotomy (no visceral perforation during surgery).
Cows were randomly assigned to 1 of 2 preoperative skin-preparations protocols with chlorhexidine used as an antiseptic. A standard protocol (3 minutes [min] cleansing scrub, tap water rinse, 3 minutes surgical scrub with a sterile one-use chlorhexidine scrub and alternate passage of alcohol and 2% chlorhexidine solution (7 minutes; n = 32) was compared with a 3 minutes abbreviated preoperative protocol, consisting of two 90 seconds period of cleansing scrub and 3 passages of 0.5% chlorhexidine gluconate in 70% in isopropyl alcohol solution (4 minutes; n = 32). Pre- and postoperative skin bacterial counts and clinical assessment of wounds 10-15 days after surgery, as well as standardized interview with the producers focused on wound infection 30 days after the surgery were used to compare both protocols.
There was no difference between protocols for absolute colony forming units (CFU) and percentage CFU reduction perioperatively as well as for surgical wound clinical score 10-15 days after the surgery. The infection rate at 30 days was 10.5% (6/57) but no significant difference was observed between protocols 10% (3/30) versus 11.5% (3/27).
An abbreviated preoperative protocol using nonsterile reusable material can be as effective as a standard protocol using sterile one-use brush in reducing skin microflora and preventing surgical wound infection.
在野外环境中比较牛站立式剖腹术的两种术前手术部位处理方案。
队列研究。
接受清洁站立式剖腹术(手术期间无内脏穿孔)的奶牛(n = 73)。
奶牛被随机分配到两种术前皮肤准备方案中的一种,使用洗必泰作为防腐剂。将标准方案(3分钟清洗擦洗、自来水冲洗、用无菌一次性洗必泰擦洗进行3分钟手术擦洗,并交替使用酒精和2%洗必泰溶液(7分钟;n = 32))与一种3分钟的简化术前方案进行比较,该简化方案包括两个90秒的清洗擦洗阶段和3次使用70%异丙醇溶液中的0.5%葡萄糖酸氯己定(4分钟;n = 32)。术前和术后的皮肤细菌计数以及术后10 - 15天伤口的临床评估,以及对生产者进行的聚焦于术后30天伤口感染的标准化访谈,用于比较两种方案。
两种方案在围手术期的绝对菌落形成单位(CFU)和CFU减少百分比以及术后10 - 15天手术伤口临床评分方面没有差异。30天时的感染率为10.5%(6/57),但两种方案之间未观察到显著差异,分别为10%(3/30)和11.5%(3/27)。
使用非无菌可重复使用材料的简化术前方案在减少皮肤微生物群和预防手术伤口感染方面可与使用无菌一次性刷子的标准方案一样有效。