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外科洗手消毒:实验研究

Surgical hand antisepsis: experimental study.

作者信息

Izaguirre Aldo, Govela Arantza, Delgado Ismael, Troncoso Carlos Mateos, Parra María, Viaña Enrique Álvarez

机构信息

Universidad Autónoma de Tamaulipas, Tampico, Mexico.

出版信息

Ann Surg Treat Res. 2018 Jul;95(1):1-6. doi: 10.4174/astr.2018.95.1.1. Epub 2018 Jun 26.

Abstract

PURPOSE

Nosocomial infections account for one of the most serious complications in hospitalized patients around the world. Surgical site infections have significant economic implications, and surgical antisepsis plays an important role in such processes.

METHODS

With prior approval by the Institutional Review Board and informed consent, 10 volunteers were randomly assigned to 3 protocols on hand antisepsis: protocol A (chloroxylenol 3%), protocol B (benzalkonium chloride at 1%), and protocol C (ethyl alcohol 61%, 1% chlorhexidine gluconate). Smears from both hands were cultured after each hand pro tocol (t0) and at the end of suturing (t1). Colony forming units were counted (CFUs on blood agar dishes) with digital counting software (Open CFU). Friedman test was used to compare the mean values among the groups, and a Bonferroni correction was made to determine the dissimilar group, with a P = 0.015.

RESULTS

At t0 for protocol A the CFU count was 82.8 ± 1.3; protocol B was 9.7 ± 30; protocol C was 0.1 ± 0.3 (P < 0.001). At t1 for protocol A the CFU was 80.7 ± 89.4; protocol B was 7.5 ± 32; protocol C was 0.0 ± 0.0 (P < 0.001). No adverse events were present among the subjects.

CONCLUSION

Ethyl alcohol at 61% with 1% chlorhexidine gluconate showed higher efficacy than the traditional washing antiseptics.

摘要

目的

医院感染是全球住院患者最严重的并发症之一。手术部位感染具有重大的经济影响,手术消毒在这一过程中起着重要作用。

方法

经机构审查委员会事先批准并获得知情同意后,10名志愿者被随机分配到3种手部消毒方案:方案A(3%对氯间二甲苯酚)、方案B(1%苯扎氯铵)和方案C(61%乙醇、1%葡萄糖酸氯己定)。在每种手部消毒方案实施前(t0)和缝合结束时(t1)采集双手涂片进行培养。使用数字计数软件(Open CFU)对血琼脂平板上的菌落形成单位进行计数(CFU)。采用Friedman检验比较各组平均值,并进行Bonferroni校正以确定差异组,P = 0.015。

结果

在t0时,方案A的CFU计数为82.8±1.3;方案B为9.7±30;方案C为0.1±0.3(P<0.001)。在t1时,方案A的CFU为80.7±89.4;方案B为7.5±32;方案C为0.0±0.0(P<0.001)。受试者中未出现不良事件。

结论

61%乙醇与1%葡萄糖酸氯己定联合使用的消毒效果优于传统的洗手消毒剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba61/6024083/908742ca980c/astr-95-1-g001.jpg

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