Sebben J E
J Am Acad Dermatol. 1983 Nov;9(5):759-65. doi: 10.1016/s0190-9622(83)70192-1.
The skin cannot be sterilized because approximately 20% of the resident flora are beyond the reach of surgical scrubs and antiseptics. The goal of surgical preparation of the skin with antiseptics is to remove transient and pathogenic microorganisms on the skin surface and to reduce the resident flora to a low level. Four antiseptics which have been popular over the past two decades are discussed. Benzalkonium chloride is somewhat unstable on the skin and is too prone to contamination to be in general use. Hexachlorophene is not recommended due to narrow spectrum and risks secondary to percutaneous absorption. The iodophors are excellent antiseptics, but recent studies raise questions about effectiveness and contamination. Chlorhexidine is a very safe and effective antiseptic. Comparison studies with chlorhexidine, hexachlorophene, and iodophors show chlorhexidine to be the most effective agent. Chlorhexidine can be toxic to the middle ear and irritating to the eyes with direct contact. Caution should be used in these areas with chlorhexidine and other antiseptics.
皮肤无法被彻底消毒，因为大约20%的常驻菌群处于手术刷洗和防腐剂难以触及的部位。使用防腐剂对皮肤进行手术准备的目的是清除皮肤表面的暂住菌和致病菌，并将常驻菌群数量降至低水平。本文讨论了过去二十年来常用的四种防腐剂。苯扎氯铵在皮肤上 somewhat unstable（此处原文有误，推测可能是“有些不稳定”），且极易被污染，因此一般不使用。由于六氯酚抗菌谱窄且存在经皮吸收的风险，所以不建议使用。碘伏是优秀的防腐剂，但最近的研究对其有效性和污染问题提出了质疑。洗必泰是一种非常安全有效的防腐剂。与洗必泰、六氯酚和碘伏的比较研究表明，洗必泰是最有效的药剂。洗必泰直接接触中耳时可能有毒，接触眼睛时会有刺激性。在这些部位使用洗必泰和其他防腐剂时应谨慎。
