术前皮肤消毒:2%洗必泰乙醇优于聚维酮碘
BACKGROUNDSince the patient’s skin is a major source of pathogens that cause surgical-site infection,optimization of preoperative skin antisepsis may decrease postoperative infections.We hypothesized that preoperative skin cleansing with chlorhexidine–alcohol is more protective against infection than is povidone–iodine.
METHODS
We randomly assigned adults undergoing clean-contaminated surgery in six hospitals to preoperative skin preparation with either chlorhexidine–alcohol scrub or povidone–iodine scrub and paint. The primary outcome was any surgical-site infection within 30 days after surgery. Secondary outcomes included individual types of surgical-site infections.
RESULTS
A total of 849 subjects (409 in the chlorhexidine–alcohol group and 440 in the povidone–iodine group) qualified for the intention-to-treat analysis. The overall rate of surgical-site infection was significantly lower in the chlorhexidine–alcohol group than in the povidone–iodine group (9.5% vs. 16.1%; P = 0.004; relative risk,0.59; 95% confidence interval, 0.41 to 0.85). Chlorhexidine–alcohol was significantly more protective than povidone–iodine against both superficial incisional infections (4.2% vs. 8.6%, P = 0.008) and deep incisional infections (1% vs. 3%,P = 0.05) but not against organ-space infections (4.4% vs. 4.5%). Similar results were observed in the per-protocol analysis of the 813 patients who remained in the study during the 30-day follow-up period. Adverse events were similar in the two study groups.
CONCLUSIONS
Preoperative cleansing of the patient’s skin with chlorhexidine–alcohol is superior to cleansing with povidone–iodine for preventing surgical-site infection after cleancontaminated surgery. (ClinicalTrials.gov number, NCT00290290.)
予2%洗必泰乙醇用于术前皮肤消毒不仅在预防手术部位感染优于聚维酮碘,在置管时予2%洗必泰乙醇消毒置管部位皮肤也可降低导管相关血流感染,寻遍了它,都没哎{:1_10:} 用0.5%洗必泰醇(70%)溶液,其效力约与碘酊相等,但无皮肤刺激,亦不染色,因而特别适用于面部、会阴部及儿童的术前准备。 (9.5% vs. 16.1%; P = 0.004; relative risk,0.59; 95% confidence interval, 0.41 to 0.85). 使用不同消毒液,手术部位感染率差别不小啊! 哦,天哪,我是文盲了。真是惭愧,全英文的看不懂了。 “0.5%洗必泰醇(70%)溶液”容易见到,“2%洗必泰乙醇”好像找不到啊。 楚楚老师,现在您们医院开始用洗必泰醇消毒液用于手术前皮肤消毒了么?谢谢!
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