Comparative clinical effectiveness of preoperative skin antiseptic preparations of chlorhexidine gluconate and povidone iodine for preventing surgical site infections in dogs

Abstract

Contamination of surgical sites often resulting from inadequate surgical site preparation and poor asepsis is a common cause of surgical site infection (SSI) and postoperative complications. Standard practice ensuring preoperative skin disinfection helps to prevent the incidence of SSI. The choice of antiseptic therefore poses a serious counterbalance for the surgeon. This study was carried out to determine whether skin asepsis immediately prior to surgical site incision will reduce skin microbial burden that may potentiate the incidence of SSI and to compare the clinical effectiveness of chlorhexidine gluconate B.P 0.3%W/V, Cetrimide B.P 3.05 W/V (CG + Cetrimide) against povidone iodine 10% (PI) in pre-surgical skin preparation and asepsis in dogs. A total of 15 dogs were used for the study. Both side of each dog was used for the study, right side for CG + Certrimide and left side for PI; (n = 30). Aseptic agents’ chlorhexidine gluconate 0.3% and Cetrimide 3.0% and povidine iodine 10% were used as pre surgical scrub solutions prior to surgery. Swab samples were evaluated before scrubbing, 0, 30, 60 and 90 min after scrubbing. Percent reductions of bacterial colony forming units were determined for all site scrub techniques. Mixed-design ANOVA results revealed significant difference (P < 0.05) within groups and no significant difference (P > 0.05) in the disinfectant effects between groups treated with CG + Cetrimide and povidone iodine respectively across the various time periods. Changes in the mean bacteria count were observed to be equivalent using CG + Cetrimide and povidone iodine. It was concluded that there was no significant difference between CG + Cetrimide and PI in preoperative surgical skin preparations.

Efficiency of octenidine dihydrochloride alcohol combination compared to ethanol based skin antiseptics for preoperative skin preparation in dogs

“…The lottery was performed by selecting one of sixty folded pieces of paper from a bag that contained 30 names of group O and 30 of group C. The person taking the samples (FE) was not able to be blinded to the treatment process, as the different solutions used were visually distinguishable. The sample size was chosen based on comparable studies and set to n = 30 per group [22][23][24][26][27][28][29]. After induction of anesthesia (non-standardized protocols adjusted to the clinical needs of each dog) the surgical field was clipped, and the first samples were taken using both techniques (T1 WDS and T1 CP in two separate skin areas located centrally along the planned incision site).…”

“…Perioperative skin disinfection is a crucial point [21], because 80% of bacteria causing SSIs originate from the patient's skin [2]. Despite this, there have only been a few published studies about skin antisepsis in dogs [22][23][24][25][26][27][28][29][30][31][32][33][34]. Chlorhexidine remains the most frequently used antiseptic in veterinary and human medicine, even though not enough studies are available proving a clear benefit of using chlorhexidine containing antiseptics when compared to other alcohol based skin preparations without additional biocide [4,22,23,26,27,29].…”

“…Despite this, there have only been a few published studies about skin antisepsis in dogs [22][23][24][25][26][27][28][29][30][31][32][33][34]. Chlorhexidine remains the most frequently used antiseptic in veterinary and human medicine, even though not enough studies are available proving a clear benefit of using chlorhexidine containing antiseptics when compared to other alcohol based skin preparations without additional biocide [4,22,23,26,27,29]. This recommendation for skin antisepsis is also contradictory to current guidelines of wound antisepsis which state that chlorhexidine should be replaced by modern antiseptics [35][36][37].…”

Description of non‐brachycephalic canine conjunctival microbiome before and after application of an antiseptic preparation

“…[7][8][9][10][11] These protocols have demonstrated similar reductions in bacterial load when used in veterinary medicine utilizing chlorhexidine gluconate, chlorhexidine diacetate, and povidone-iodine antiseptics. [12][13][14][15] In both human and veterinary medicine, the specifics of ocular preparation are not standardized. The American Academy of Ophthalmology has published guidelines to attempt to standardize aspects of ocular surgical preparation by recommending use of a povidone-iodine 5% solution applied to the conjunctival cul-de-sac with a contact time of 3 min.…”

“…Surgical preparation practices in veterinary medicine are derived from human protocols identifying reductions in commensal bacteria following use of common antiseptics including chlorhexidine gluconate, povidone‐iodine, and hexachlorophene 7–11 . These protocols have demonstrated similar reductions in bacterial load when used in veterinary medicine utilizing chlorhexidine gluconate, chlorhexidine diacetate, and povidone‐iodine antiseptics 12–15 …”