Antiseptic Bathing Research Articles

A systems approach to preoperative surgical patient skin preparation

Background The merits of a systems approach to preoperative surgical patient skin preparation are presented. A “system” may be defined as the addition of an antiseptic bath(s) or shower(s) within 24 hours before the application of a Food and Drug Administration–compliant patient preoperative skin preparation at the time of surgery. The expected outcome from this added effort is a further reduction in the transient and normal flora that contaminate the skin surrounding the operative site, and contribute to surgical infections. The Centers for Disease Control and Prevention has recommended the addition of this step to the preoperative site preparation regimen. Methods A human in vivo study comparing an alcohol-based (ethanol) system to an iodine-based approach, and 2 sets of clinical observations, are presented here. Results The data confirm the utility of the systems approach. The in vivo study demonstrates that significant reductions (≥2 log 10) in normal and transient flora can be achieved quickly and maintained out to 72 hours after the surgery, allowing for wound closure in a prolonged state of skin antisepsis. Clinical observations support the in vivo findings. After initiation of the system, the infection rates for the monitored procedures have decreased. Conclusions The data presented here delineate the merits of a systems approach to preoperative surgical patient skin preparation. This approach has a positive impact on infection rates and may reduce the additional costs associated with this preventable event.

Irritant reactions to an antiseptic bath emollient

BACKGROUND: Antiseptic bath emollients are important in the management of atopic eczema, helping to reduce the Staphylococcus aureus load and the frequency and severity of infective relapse. METHODS: We report seven cases who developed an irritant reaction to Oilatum Plus® (OP), an antiseptic bath emollient containing benzalkonium chloride (6%) and triclosan (2%). RESULTS: A typical feature is the lack of itch and patients often report only slight discomfort, in contrast with atopic eczema. Clinically, there is erythema, sometimes surmounted or surrounded by desquamation, often of an unusual brown colour. The most frequently involved areas are skin flexures and otherwise occluded skin, which may be explained by an increased penetration of the offending agent into the skin. In three cases, the reaction followed excessive or inappropriate use of OP bath emollient, but in other cases the reaction occurred even with apparently correct use of OP. CONCLUSION: Individual susceptibility to an irritant reaction from benzalkonium chloride and/or triclosan seems likely. The clinician should be aware of the potential for irritation from OP, and should advise patients on its correct use. (J Dermatol Treat (2000) 11: 263-267)

Do preoperative chlorhexidine baths reduce the risk of infection after vascular reconstruction?

Pathogenic organisms are frequently present on the skin of vascular patients and are a risk factor for postoperative infection. A randomised trial of preoperative antiseptic baths was performed in 64 high risk vascular patients to determine whether two chlorhexidine baths could reduce the incidence of postoperative sepsis. Although pathogenic organisms were isolated preoperatively in 35% of patients, the wound infection rate after chlorhexidine baths (26%) was greater, though not significantly, than after baths with non-medicated soap (11%). An alternative theory that infection arises via lymphatics in the limb was not confirmed when organisms could not be isolated from groin lymph nodes in a group of 35 patients. The case for preoperative antiseptic regimes in vascular surgery remains unproven.

Newer studies on the epidemiology of fungous infections of the feet.

were really produced in this manner, it would justify the continuation of such attempted prophylactic measures as: the exclusion of persons with fungous infection of the feet from the use of public bathing facilities; the use of disinfectants on the floors of shower and locker rooms; the installation of antiseptic foot baths; and the use of individual disposable slippers. These and other rituals have been recommended over and

A BACTERIOLOGIC STUDY OF A NEW SANIGENIC FLOORING

Epidermophytosis and plantar warts are diseases that are transmitted primarily through the contact of bare feet and contaminated floors. Thus floor sanitation is a problem in locker rooms, shower rooms and runways of swimming pools. The commonly accepted procedure of control consists in placing footbaths containing antiseptic solutions in doorways to the swimming pool or shower rooms. By this means the feet are at least momentarily immersed in an antiseptic bath which undoubtedly removes organisms from the feet and also destroys many of them. When the footbath is the sole means of prophylaxis, the bather returns to his locker on contaminated floors and may reinfect his feet before dressing. Realizing that reinfection may result from contaminated floors, many establishments as a routine wash all floors carefully and follow this with disinfection. Owing to the frequently continuous use of the locker rooms, showers and swimming pools, the cleaning and disinfection of

Antiseptic Treatment of Smallpox.

Detroit, Mich, May 2, 1901. To the Editor: —InThe Journalof March 16, page 771, there is an abstract of a paper of mine. If the abstract is allowed to stand without further comment it will injure me in my claim to priority in the antiseptic treatment of smallpox. By it the medical profession might infer that I had only suggested a local (antiseptic) method treatment, whereas the whole burthen of my endeavor as to treatment since January 14, 1895, at which time I delivered an original paper on the pathology and antiseptic treatment of smallpox, before the Detroit Medical and Library Association—has been to induce medical men to evolve a complete and perfect treatment in which antiseptic baths should be the principal and effective part employed in the management of variola. On the same date, 1895, I originally announced the principle that the true smallpox only extends so