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Bacterial colonization of the skin following aseptic preoperative preparation and impact of the use of plastic adhesive drapes
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital, Örebro, Sweden; .
Örebro University Hospital. Department of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-5939-2932
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Health Care Sciences; Department of Nursing, Umeå University, Umeå, Sweden.ORCID iD: 0000-0001-5403-4183
2013 (English)In: Biological Research for Nursing, ISSN 1099-8004, E-ISSN 1552-4175, Vol. 15, no 2, p. 242-248Article in journal (Refereed) Published
Abstract [en]

Surgical site contamination, for example, with coagulase-negative staphylococci, probably derives from both the patient’s own skin flora and those of the surgical team. Despite preoperative antiseptic preparation with chlorhexidine solution, complete sterilization of the skin is not possible and gradual recolonization will occur. Plastic adhesive drape is an established method used to prevent direct wound contamination from adjacent skin. In this study, the time to skin recolonization after antiseptic preparation was measured and the impact of using plastic adhesive drape on this recolonization was evaluated. Repeated bacterial sampling using three different methods over 6 hr was conducted after antiseptic preparation in 10 volunteers. Recolonization of skin was observed after 30 min with plastic drape and after 60 min without plastic drape; there were significantly more positive cultures with the plastic drape than without (31% vs. 7.5%, respectively, p < .001). Sampling with a rayon swab was the most sensitive sampling method. In conclusion, covering the skin with a plastic adhesive drape seems to hasten recolonization of the skin after antiseptic preparation. However, clinical trials to confirm this finding are warranted.

Place, publisher, year, edition, pages
2013. Vol. 15, no 2, p. 242-248
Keywords [en]
recolonization, disinfection, plastic drape, chlorhexidine solution
National Category
Surgery Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-25334DOI: 10.1177/1099800411430381ISI: 000314367500015PubMedID: 22278031Scopus ID: 2-s2.0-84873426936OAI: oai:DiVA.org:oru-25334DiVA, id: diva2:547063
Note

Karin Falk-Brynhildsen is also affiliated to Department of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital 

Bo Söderquist i also affiliated to Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden 

Ulrica G. Nilsson is also affiliated to Department of Nursing, Umeå University, Umeå, Sweden 

Available from: 2012-08-27 Created: 2012-08-27 Last updated: 2018-05-15Bibliographically approved
In thesis
1. The effect  of peroperative skin preparation on bacterial growth during cardiac surgery
Open this publication in new window or tab >>The effect  of peroperative skin preparation on bacterial growth during cardiac surgery
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Routine products are used and procedures are followed in order to prevent and minimize the bacterial contamination of the surgical wound, and thus reduce the risk of postoperative wound infections. The overall aim of this thesis was to investigate the effect of different preoperative skin preparation before cardiac surgery.

In study I, 10 healthy volunteers were compared in time to recolonization of the skin and bacterial growth with or without plastic adhesive drape. Bacterial samples were taken as paired samples on both side of the sternum. Plastic drape on disinfected skin seems to hasten recolonization compared with bare skin.

In study II, 135 cardiac surgery patients were comparing plastic adhesive drape versus bare skin on the chest regarding intra-operative bacterial growth. Plastic adhesive drape did not reduce the bacterial recolonization or wound contamination, P. acnes colonizes males more often than females and P. acnes is not affected by disinfection with 0.5% chlorhexidine in ethanol.

Study III, compared the leg harvesting site with or without microbal skin sealant in 135 CABG patients regarding intraoperative bacterial growth and postoperative wound infection. Almost no bacterial growth was found during surgery regardless of the use of microbial skin sealant and bare skin. A high incidence of postoperative wound infections (16.8%) in 2 month follow up was present and SSI was largely caused by S. aureus, i.e. other bacterial species than observed intraoperative.

Study IV, a descriptive study using phenotypic and genotypic methods investigate susceptibility to chlorhexidine among S. epidermidis indicating that S. epidermidis isolates following preoperative skin disinfection are sensitive tochlorhexidine.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 99
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 50
Keywords
OR, plastic adhesive drape, microbial skin sealent, chlorhexidine
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-31039 (URN)978-91-7668-978-3 (ISBN)
Public defence
2013-12-16, Wilandersalen, Universitetssjukhuset i Örebro, S. Grev Rosengatan 18, 703 62 Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-09-30 Created: 2013-09-30 Last updated: 2017-09-15Bibliographically approved

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Falk-Brynhildsen, KarinSöderquist, BoNilsson, Ulrica G.

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