Use of a quaternary ammonium compound for the surgical scrub

Swan, Henry; Gonzalez, Richard I.; Harris, Adelaide; Couslon, C.; Hopwood, M.L.

doi:10.1016/0002-9610(49)90375-x

Cited by 4 publications

(1 citation statement)

References 45 publications

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“…As these commonplace topical agents were developed throughout the mid-1900s, one of the pioneers of open-heart surgery poignantly reflected on the contemporary beliefs of the day regarding PSP procedures: “that by the use of surface agents perfection in the sterilization of skin (as in everything else) is impossible and must remain, as it always has been, a goal and a standard for relative comparison [ 11 ]”. Indeed, our current understanding of PSPs and their antimicrobial efficacy remains scarcely changed—a fact which has been recently reemphasized in a thorough 2021 meta-analysis of PVP-I and CHG PSPs which states, “Human skin cannot be sterilized even by intense disinfection [ 10 ]”.…”

Section: Introductionmentioning

confidence: 99%

A Porcine Model for the Development and Testing of Preoperative Skin Preparations

et al. 2022

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Clinical preoperative skin preparations (PSPs) do not eradicate skin flora dwelling in the deepest dermal regions. Survivors constitute a persistent infection risk. In search of solutions, we created a porcine model intended for PSP developmental testing. This model employed microbiological techniques sensitive to the deep-dwelling microbial flora as these microorganisms are frequently overlooked when using institutionally-entrenched testing methodologies. Clinical gold-standard PSPs were assessed. Ten Yorkshire pigs were divided into two groups: prepared with either povidone iodine (PVP-I) or chlorhexidine gluconate (CHG) PSP. Bioburdens were calculated on square, 4 cm by 4 cm, full-thickness skin samples homogenized in neutralizing media. Endogenous bioburden of porcine skin (3.3 log10 CFU/cm2) was consistent with natural flora numbers in dry human skin. On-label PSP scrub kits with PVP-I (n = 39) or CHG (n = 40) failed the 2–3 log10-reduction criteria established for PSPs by the Food and Drug Administration (FDA), resulting in a 1.46 log10 and 0.58 log10 reduction, respectively. Porcine dermal microbiota mirrored that of humans, displaying abundant staphylococcal species. Likewise, histological sections showed similarity in hair follicle depths and sebaceous glands (3.2 ± 0.7 mm). These shared characteristics and the considerable fraction of bacteria which survived clinical PSPs make this model useful for developmental work.

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Section: Introductionmentioning

confidence: 99%