Influence of skin preparation on surgical site infection and lift of adhesive surgical drapes.

OBJECTIVE

To determine the influence on surgical site infection (SSI) rates when using 0.7% iodophor and 74% isopropyl alcohol versus 2% chlorhexidine and 70% isopropyl alcohol. To evaluate the adherence of an iodophor-impregnated surgical incise drape when used in conjunction with 0.7% iodophor and 74% isopropyl alcohol.

STUDY DESIGN

Combines retrospective control and prospective data.

SAMPLE POPULATION

This study included dogs and cats, 653 retrospective cases and 435 prospective cases, with 447 incisions.

METHODS

The SSI rate of a 2% chlorhexidine and 70% isopropyl alcohol preparation was retrospectively reviewed. The prospective population received 0.7% iodophor and 74% isopropyl alcohol; risk factors for SSI were evaluated and incise drape lift was documented.

RESULTS

A 1.8% difference in SSI between the chlorhexidine group and 0.7% iodophor and 74% isopropyl alcohol group was found (p = .25). The drape lift was 13.2%. Drape lift (p = .026), increased body weight (p = .008), and the use of glutaraldehyde for instrument sterilization (p = .055) were associated with an increased risk of SSI development.

CONCLUSION

The 0.7% iodophor and 74% isopropyl alcohol treatments demonstrated similar effectiveness to 2% chlorhexidine and 70% isopropyl alcohol in skin preparation. Using an iodophor-impregnated drape with 0.7% iodophor and 74% isopropyl alcohol reduced both drape lift and the risk of SSI.

CLINICAL SIGNIFICANCE

These findings support the combined use of an incise drape with 0.7% iodophor and 74% isopropyl alcohol preparation, provide evidence against the use of glutaraldehyde, and indicate that heavier patients have an increased risk of SSI.