Kargupta Roli, Hull Garret J, Rood Kyle D, Galloway James, Matthews Clinton F, Dale Paul S, Sengupta Shramik
Department of Bioengineering, University of Missouri, 252 Agricultural Engineering Building, Columbia, MO, 65211, USA.
Department of Surgery, University Hospital, Columbia, MO, USA.
Ann Clin Microbiol Antimicrob. 2015 Apr 2;14:20. doi: 10.1186/s12941-015-0076-2.
The Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) report published in 2009 shows that there were about 16,000 cases of surgical site infection (SSI) following ~ 850,000 operative procedures making SSI one of the most predominant infection amongst nosocomial infections. Preoperative skin preparation is a standard procedure utilized to prevent SSIs thereby improving patient outcomes and controlling associated healthcare costs. Multiple techniques/ products have been used for pre-operative skin preparation, like 2 step scrubbing and painting, 2 step scrubbing and drying, and 1 step painting with a drying time. However, currently used products require strict, time consuming and labor-intensive protocols that involve repeated mechanical scrubbing. It can be speculated that a product requiring a more facile protocol will increase compliance, thus promoting a reduction in SSIs. Hence, the antimicrobial efficacy of a spray-on foaming formulation containing Betadine (povidone-iodine aerosol foam) that can be administered with minimum effort is compared to that of an existing formulation/technique (Wet Skin Scrub).
In vitro antimicrobial activities of (a) 5% Betadine delivered in aerosolized foam, (b) Wet Skin Scrub Prep Tray and (c) liquid Betadine are tested against three clinically representative microorganisms (S. aureus, S. epidermidis and P. aeruginosa,) on two surfaces (agar-gel on petri-dish and porcine skin). The log reduction/growth of the bacteria in each case is noted and ANOVA statistical analysis is used to establish the effectiveness of the antimicrobial agents, and compare their relative efficacies.
With agar gel as the substrate, no growth of bacteria is observed for all the three formulations. With porcine skin as the substrate, the spray-on foam's performance was not statistically different from that of the Wet Skin Scrub Prep technique for the microorganisms tested.
The povidone-iodine aerosolized foam could potentially serve as a non-labor intensive antimicrobial agent for surgical site preparation.
美国疾病控制与预防中心（CDC）2009年发布的国家医疗安全网络（NHSN）报告显示，在约850,000例手术操作后发生了约16,000例手术部位感染（SSI），这使得SSI成为医院感染中最主要的感染之一。术前皮肤准备是用于预防SSI的标准程序，从而改善患者预后并控制相关医疗费用。多种技术/产品已用于术前皮肤准备，如两步擦洗和涂抹、两步擦洗和干燥以及一步涂抹并等待干燥时间。然而，目前使用的产品需要严格、耗时且 labor-intensive 的方案，包括重复的机械擦洗。可以推测，一种需要更简便方案的产品将提高依从性，从而促进SSI的减少。因此，将一种含聚维酮碘气雾剂泡沫的喷雾式发泡制剂（其使用时所需 effort 最小）的抗菌效果与现有制剂/技术（湿皮肤擦洗）进行比较。
对（a）以气雾剂泡沫形式提供的5%聚维酮碘、（b）湿皮肤擦洗准备托盘和（c）液体聚维酮碘的体外抗菌活性，在两种表面（培养皿上的琼脂凝胶和猪皮）上针对三种临床代表性微生物（金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌）进行测试。记录每种情况下细菌的对数减少/生长情况，并使用方差分析统计分析来确定抗菌剂的有效性，并比较它们的相对疗效。
以琼脂凝胶为底物时，所有三种制剂均未观察到细菌生长。以猪皮为底物时，对于所测试的微生物，喷雾式泡沫的性能与湿皮肤擦洗准备技术在统计学上无差异。
聚维酮碘气雾剂泡沫有可能作为一种非 labor-intensive 的手术部位准备抗菌剂。
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