Preoperative skin and nail preparation of the foot: Comparison of the efficacy of 4 different methods in reducing bacterial load - 24/08/11
, Marta Elena Losa Iglesias, PhD c, Luis Alou Cervera, BSc, PhD b, David Sevillano Fernández, BPharm b, José Prieto Prieto, MD, PhD b
Reprint requests: Ricardo Becerro de Bengoa Vallejo, DPM, PhD, Escuela Universitaria de Enfermería, Fisioterapia y Podología, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain.Abstract |
Background |
Orthopedic surgical procedures involving the foot and ankle are associated with high rates of infection. The optimal method of preparing the skin and nails for foot and ankle surgery remains unknown.
Objective |
This study was conducted to compare the efficacy of 4 different methods of skin and nail preparation of the foot using various antiseptic solutions.
Methods |
In this prospective, randomized study, 4 methods of skin and nail preparation were compared in terms of their efficacy in eliminating bacteria from the hallux nailfold and first web space of the normal foot in 28 healthy adult volunteers. Efficacy was determined by evaluating the difference in the total bacterial load before and after skin preparation. The foot-preparation solutions evaluated were 4% chlorhexidine gluconate, 70% isopropyl alcohol, and 7.5% to 10% povidone-iodine.
Results |
The addition of alcohol to povidone-iodine was found to increase the efficacy of the preparation method. The nailfold remained contaminated after any of the preoperative skin- and nail-preparation methods studied.
Limitations |
This study did not measure clinically relevant infections, and the results may not correlate with decreased rates of infection after surgery.
Conclusion |
Incorporation of alcohol and povidone-iodine into the preoperative skin- and nail-preparation process may help reduce the bacterial load. Every effort should be made to lower the risk of contamination from the nail.
Le texte complet de cet article est disponible en PDF.Key words : antiseptic, bacterial load, foot surgery, infection, preoperative skin preparation
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 61 - N° 6
P. 986-992 - décembre 2009 Retour au numéro
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