Charles Daniel, Heal Clare F, Delpachitra Meth, Wohlfahrt Michael, Kimber Debbie, Sullivan Julie, Browning Sheldon, Saednia Sabine, Hardy Alexandra, Banks Jennifer, Buttner Petra
Discipline of General Practice and Rural Medicine (Charles, Heal, Delpachitra, Wohlfahrt, Hardy, Banks), Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Mackay; Anton Breinl Research Centre for Health Systems Strengthening (Heal), Australian Institute of Tropical Health and Medicine, James Cook University, Townsville; Mackay Institute of Research and Innovation (Heal), Townsville; Paul Hopkins Medical Centre (Kimber, Sullivan), Mackay; Smart Scan Mackay (Browning), Mackay; Mareeba Medical Centre (Saednia), Mareeba; Tropical Health Solutions (Buttner), Townsville; Centre for Chronic Disease Prevention (Buttner), James Cook University, Cairns, Australia.
Discipline of General Practice and Rural Medicine (Charles, Heal, Delpachitra, Wohlfahrt, Hardy, Banks), Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Mackay; Anton Breinl Research Centre for Health Systems Strengthening (Heal), Australian Institute of Tropical Health and Medicine, James Cook University, Townsville; Mackay Institute of Research and Innovation (Heal), Townsville; Paul Hopkins Medical Centre (Kimber, Sullivan), Mackay; Smart Scan Mackay (Browning), Mackay; Mareeba Medical Centre (Saednia), Mareeba; Tropical Health Solutions (Buttner), Townsville; Centre for Chronic Disease Prevention (Buttner), James Cook University, Cairns, Australia
CMAJ. 2017 Aug 8;189(31):E1008-E1016. doi: 10.1503/cmaj.161460.
Preoperative skin antisepsis is routine practice. We compared alcoholic chlorhexidine with aqueous chlorhexidine for skin antisepsis to prevent surgical site infection after minor skin excisions in general practice.
We conducted this prospective, multicentre, randomized controlled trial in 4 private general practices in North Queensland, Australia, from October 2015 to August 2016. Consecutive adult patients presenting for minor skin excisions were randomly assigned to undergo preoperative skin antisepsis with 0.5% chlorhexidine in 70% ethanol (intervention) or 0.5% chlorhexidine aqueous solution (control). Our primary outcome was surgical site infection within 30 days of excision. We also measured the incidence of adverse reactions.
A total of 916 patients were included in the study: 454 underwent antisepsis with alcoholic chlorhexidine and 462 with aqueous chlorhexidine. Of these, 909 completed follow-up. In the intention-to-treat analysis of cases available at follow-up, there was no significant difference in the incidence of surgical site infection between the alcoholic chlorhexidine arm (5.8%, 95% confidence interval [CI] 3.6% to 7.9%) and the aqueous chlorhexidine arm (6.8%, 95% CI 4.5% to 9.1%). The attributable risk reduction was 0.010 (95% CI -0.021 to 0.042), the relative risk was 0.85 (95% CI 0.51 to 1.41), and the number needed to treat to benefit was 100. Per protocol and sensitivity analyses produced similar results. The incidence of adverse reactions was low, with no difference between groups ( = 0.6).
There was no significant difference in efficacy between alcoholic and aqueous chlorhexidine for the prevention of surgical site infection after minor skin excisions in general practice. https://www.anzctr.org.au, no. ACTRN12615001045505.
术前皮肤消毒是常规操作。我们比较了酒精洗必泰与水洗洗必泰用于皮肤消毒以预防全科医疗中微小皮肤切除术后手术部位感染的效果。
2015年10月至2016年8月，我们在澳大利亚北昆士兰的4家私立全科诊所进行了这项前瞻性、多中心、随机对照试验。连续前来接受微小皮肤切除的成年患者被随机分配接受用70%乙醇中的0.5%洗必泰进行术前皮肤消毒（干预组）或0.5%水洗洗必泰溶液（对照组）。我们的主要结局是切除术后30天内的手术部位感染。我们还测量了不良反应的发生率。
共有916例患者纳入研究：454例接受酒精洗必泰消毒，462例接受水洗洗必泰消毒。其中，909例完成随访。在对随访时可得病例的意向性分析中，酒精洗必泰组手术部位感染发生率（5.8%，95%置信区间[CI] 3.6%至7.9%）与水洗洗必泰组（6.8%，95% CI 4.5%至9.1%）之间无显著差异。归因风险降低为0.010（95% CI -0.021至0.042），相对风险为0.85（95% CI 0.51至1.41），需治疗获益人数为100。按方案分析和敏感性分析产生了相似结果。不良反应发生率较低，组间无差异（ = 0.6）。
在全科医疗中，酒精洗必泰与水洗洗必泰在预防微小皮肤切除术后手术部位感染的疗效上无显著差异。https://www.anzctr.org.au，编号ACTRN12615001045505 。
