Comparison of hydroalcoholic rubbing and conventional chlorhexidine scrubbing for aseptic skin preparation in dogs

Abstract

Objective To compare preparation time, ease of application, and elimination of skin contamination of 3 skin preparation methods for asepsis. Study design Experimental study. Animals Healthy dogs (n = 6) with no clinical signs of skin disease. Methods Three sites on each dog were randomly allocated to 1 of 3 preparation protocols for asepsis: (1) 5 scrubbings with chlorhexidine gluconate and rinsing (CHXG), (2) washing with mild soap prior to 3 rubbings with hydroalcoholic solution (soap‐HAR), or (3) 3 rubbings with hydroalcoholic solution (HAR). The duration of each method of skin preparation was recorded. A Count‐Tact agar plate was placed in the center of each site before, immediately after, 1 hour after, and 3 hours after antiseptic application. Plates were cultured, and colony forming units (CFU) were counted. Results Skin preparation lasted an average of 375 seconds for CHXG, 240 seconds for soap‐HAR, and 190 seconds for HAR (P = .00049). Nine CFU (median) were cultured from the skin prior to preparation, with no difference between sites on any animal or for any method. Colony forming units were not detected at any time on any site in any dog after antiseptic application. Conclusion Rubbing with hydroalcoholic (HA) solution was as effective as CHXG and prevented bacterial growth for at least 3 hours under these experimental conditions. Rubbing with hydroalcoholic solution was also faster and easier to perform. Clinical significance Because there is currently no known resistance to HA solution, preparation of the surgical site with HAR should be considered to prevent the emergence of bacterial resistance to chlorhexidine as well as potential cross‐resistances to antibiotics. Transfer to clinical animals requires additional investigation.

Influence of clipping on bacterial contamination of canine arthrocentesis sites before and after skin preparation

“…Bacterial counts before skin preparation in this study were similar to or higher than those found in other canine studies, although different preparation solutions were used 12,13,28,35 . Bacterial reduction was not always complete.…”

“…The swab method is considered more appropriate for uneven surfaces, which is why it was used in our study 37,38 . Differences in anatomical location and methodology make direct comparisons between our study and other canine studies difficult 12,13,28 because, in those other studies, larger sites on the trunk were cultured in a surgical setting by using surgical caps, masks, and (in two studies), surgical drapes 12,13,28 …”

“…Human guidelines increasingly accept waterless hand rubs for presurgical hand washing because they are as effective as chlorhexidine and less traumatizing to the hands of surgical personnel 41 . Evaluation of products for animal site preparation in veterinary medicine is ongoing, but no difference has yet been identified in residual CFU per milliliter when any other product has been compared to traditional chlorhexidine‐based site preparation 13,28 . Alcohol‐based solutions are also considered is easier to use 13 .…”

“…Evaluation of products for animal site preparation in veterinary medicine is ongoing, but no difference has yet been identified in residual CFU per milliliter when any other product has been compared to traditional chlorhexidine‐based site preparation 13,28 . Alcohol‐based solutions are also considered is easier to use 13 . These findings lead us to conclude that arthrocentesis site preparation with waterless preparation products warrants further consideration.…”

“…The most common bacterial flora of canine skin are various Staphylococcus spp, Micrococcus spp, and Corynebacterium spp 12‐15 . In clinical cases of canine septic arthritis, the route of infection is hematogenous or by direct penetration of joints through surgery or trauma 11,16‐18 .…”