Reduktion der Vaginalflora durch präoperative Desinfektion

Abstract

In 70 gynaecological patients vaginal disinfection by povidone-iodine and chlorhexidine solution (LEC) was investigated. The preoperative bacterial spectrum corresponded to the specifications in literature. Only lactobacilli were found in fewer cases than expected, an effect, which was explained by the povidone-iodine sanitation of the vagina a day before the operation. In cases of disturbed lactobacilli flora, facultative pathogen species were found in high concentrations up to 10(6) CFU/ml. Germ reduction achieved more than 3.4 log CFU/ml in the three groups of antiseptics. Povidone-iodine left a residue of other bacteria species in one-fifth of the cases, one of the LEC-solutions only in one-tenth of the cases. B-Streptococcus, Streptococcus viridans (mitis) and Candida glabrata were found in concentrations up to 10(3) CFU/ml in the residues. In these cases, a disturbed ecology of the vagina had already existed previously. It is concluded, not to disturb normal vaginal flora needlessly before preoperative disinfection and to restore it as soon as possible after operation. The LEC solutions appeared to be a competent alternative to povidone-iodine solution in vaginal disinfection.