oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
The effect of preheated versus room-temperature skin disinfection on bacterial colonization during pacemaker device implantation: a randomized controlled non-inferiority trial
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Cardiothoracic surgery and Vascular surgery, Örebro University Hospital, Örebro, Sweden. (Perioperative nursing)
Örebro University, School of Medicine, Örebro University, Sweden. (Inflammatory Response and Infection Susceptibility Centre (iRiSC) och Perioperative nursing)ORCID iD: 0000-0001-5939-2932
(Clinical Epidemiology and Biostatistics)
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. (Perioperativ omvårdnad)ORCID iD: 0000-0001-5403-4183
2015 (English)In: Antimicrobial Resistance and Infection Control, ISSN 2047-2994, E-ISSN 2047-2994, Vol. 4, article id 44Article in journal (Refereed) Published
Abstract [en]

Background: In clinical practice, patients who are awake often comment that cold surgical skin disinfectant is unpleasant. This is not only a problem of patients’ experience; heat loss during the disinfection process is a problem that can result in hypothermia. Evidence for the efficacy of preheated disinfection is scarce. We tested whether preheated skin disinfectant was non-inferior to room-temperature skin disinfectant on reducing bacterial colonization during pacemaker implantation.

Methods: This randomized, controlled, non-inferiority trial included 220 patients allocated to skin disinfection with preheated (36 °C) or room-temperature (20 °C) chlorhexidine solution in 70 % ethanol. Cultures were obtained by swabbing at 4 time-points; 1) before skin disinfection (skin surface), 2) after skin disinfection (skin surface), 3) after the incision (subcutaneously in the wound), and 4) before suturing (subcutaneously in the wound).

Results: The absolute difference in growth between patients treated with preheated versus room-temperature skin disinfectant was zero (90 % CI −0.101 to 0.101; preheated: 30 of 105 [28.6 %] vs. room-temperature: 32 of 112 [28.6 %]). The pre-specified margin for statistical non-inferiority in the protocol was set at 10 % for the preheated disinfectant. There were no significant differences between groups regarding SSIs three month postoperatively, which occurred in 0.9 % (1 of 108) treated with preheated and 1.8 % (2 of 112) treated with room-temperature skin disinfectant.

Conclusion: Preheated skin disinfection is non-inferior to room-temperature disinfection in bacterial reduction. We therefore suggest that preheated skin disinfection become routine in clean surgery.

Place, publisher, year, edition, pages
London, United Kingdom: BioMed Central, 2015. Vol. 4, article id 44
Keywords [en]
Perioperative, Skin disinfection, Bacterial growth, Non-inferiority
National Category
Medical and Health Sciences Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
URN: urn:nbn:se:oru:diva-46423DOI: 10.1186/s13756-015-0084-1ISI: 000367371700001PubMedID: 26539295Scopus ID: 2-s2.0-85006223174OAI: oai:DiVA.org:oru-46423DiVA, id: diva2:867203
Note

Funding Agencies:

Örebro County Council Research Committee, Örebro, Sweden

Örebro University

Available from: 2015-11-04 Created: 2015-11-04 Last updated: 2018-09-04Bibliographically approved
In thesis
1. Swedish operating room nurses preventive interventions to reduce bacterial growth, surgical site infections, and increase comfort in patients undergoing surgery
Open this publication in new window or tab >>Swedish operating room nurses preventive interventions to reduce bacterial growth, surgical site infections, and increase comfort in patients undergoing surgery
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Surgical site infection is a major postoperative complication that causes patient suffering and is costly for society. The general aim of this thesis was to test and describe interventions performed by operating room (OR) nurses to prevent bacterial growth in surgical patients, with the intent to prevent surgical site infections (SSIs) whilst increase patients comfort.

In studies I and II, 220 pacemaker patients were tested to compare pre-heated skin disinfection with room-temperature skin disinfection regard-ing bacterial growth, skin temperature and patient experience. Preheated skin disinfection was not less effective compared to room-temperature skin disinfection in reducing bacterial growth after skin disinfection and there were no differences regarding SSIs three month postoperatively. Preheated skin disinfection reduces skin heat loss and was perceived as more pleas-ant compared to room-temperature skin disinfection.

In study III, 12 OR nurses were examined regarding bacterial growth on their hands and at the sterile glove cuff end after surgical hand disinfec-tion and again after wearing sterile surgical gloves during surgery. They were compared with a control group of 13 non-health care workers. OR nurses’ hands had higher amounts of bacterial growth at two of three culture sites after surgical hand disinfection compared with the control group, and the bacterial growth increased in both groups with time during surgery. There seems to be a risk of bacterial growth at the glove cuff end during surgery, involving the same type of bacteria as isolated from the hands.

In study IV, 890 OR nurses answered an online questionnaire describ-ing OR nurses interventions guided by national guidelines to reduce SSIs, such as preparation of the patient skin, patient temperature, and OR ma-terials used. The proportion of the OR nurses who complied with the national guidelines preventive interventions was high: skin disinfection solution (93.5%), drapes (97.4%) and gowns (83.8%), and double gloves (73%). However, when guidelines were lacking the interventions differed.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2017. p. 90
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 73
Keywords
skin disinfection, patient experience, skin temperature, intra-operative, surgical site infection, bacterial growth, recolonization
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-59394 (URN)978-91-7529-213-7 (ISBN)
Public defence
2017-11-10, Universitetssjukhuset i Örebro, Wilandersalen, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2017-08-25 Created: 2017-08-25 Last updated: 2017-12-05Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Wistrand, CamillaSöderquist, BoNilsson, Ulrica

Search in DiVA

By author/editor
Wistrand, CamillaSöderquist, BoNilsson, Ulrica
By organisation
School of Health and Medical Sciences, Örebro University, SwedenSchool of Medicine, Örebro University, Sweden
In the same journal
Antimicrobial Resistance and Infection Control
Medical and Health SciencesNursing

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 537 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf