Antiseptic Preparation Research Articles

Effectiveness of Preoperative Antiseptic Preparation in Transnasal Skull Base Surgery: A Randomized Three-Arm Controlled Trial

Objective: Transnasal skull-base surgery is a complex and invasive procedure that involves the use of preoperative antiseptic preparations. However, evidence supporting their use in preventing postoperative infectious complications is limited. The aim of this study is to assess the efficacy of preoperative antiseptic techniques in reducing postoperative infectious complications within 30 days of surgery. Methods: A multicenter, prospective, randomized, single-blind, three-arm trial was conducted from February 2019 to October 2021. Participants were randomized to either of three antiseptic preparation techniques: external 0.9%NaCl nasal preparation, external 0.05% chlorhexidine gluconate, or intranasal irrigation with 80 mg of gentamicin added to 1000 ml of 0.9%NaCl plus external nasal preparation with chlorhexidine gluconate 0.05%. A total of 130 adults with skull-base pathologies were randomized, 12 were excluded before randomization for failure to meet inclusion criteria (n=9) or refusal to participate (n=3). We excluded patients with evidence of infection adjacent to the surgical site, allergies to preparation methods, those who underwent craniotomy during the same admission, and pediatric patients. Results: The mean age of participants was 43.26±14.45 years. Nine patients developed postoperative infections (meningitis, n=8; sinusitis, n=2). Among the factors studied, length of surgery (p=0.002), perioperative CSF diversion (p=0.01), chordoma (p=0.004), extended approach (p=0.026), and postoperative CSF leak (p=0.025) were significantly associated with postoperative infections. There were no clinically meaningful or significant differences in the studied intervention groups regarding postoperative infectious complications. Conclusion: Preoperative antiseptic techniques failed to prefer one application to prevent postoperative infectious complications in patients who underwent endoscopic transnasal skull-base surgery.

Pre-procedural Topical Antisepsis in the Neonate: A Systematic Review Evaluating Risk Factors for Skin Injury.

Pre-procedural antisepsis is a critical component of hospital-acquired infection prevention in the neonatal intensive care unit (NICU). However, broadly utilized topical antiseptic agents pose an elevated risk of disruption to neonatal skin integrity, and evidence-based guidelines are lacking. This systematic review of the literature sought to assess and characterize the predisposing risk factors for and types of neonatal skin injury from topical antiseptic agents. A systematic search of Medline Ovid, Embase, Web of Science, CINAHL, and Cochrane Library was conducted, including academic literature providing data on neonatal skin injuries related to topical antisepsis in the NICU. A total of 19 articles (99 patients) met the inclusion criteria. Of the available data, most reported skin injuries were described in extremely preterm (98.1%) and very low birth weight (98.4%) infants. The majority of reported adverse cutaneous events were attributed to chlorhexidine preparations (74.8%), followed by octenidine (18.2%), povidone-iodine (6.1%), and isopropyl alcohol (2.0%). Erythema (40.1%), skin breakdown (23.4%), and chemical burns (17.5%) were the skin reactions reported most frequently, followed by skin irritation (8.3%), and skin necrosis (2.8%). Our findings indicate that both extremely preterm and very low birth weight infants are particularly susceptible to skin toxicities from pre-procedural antiseptic preparations. These data underscore the need for future research to support the development of guidelines which minimize iatrogenic cutaneous injuries in the neonatal population, specifically for the care of infants under 2 months of age, for whom current recommendations are lacking due to a paucity of data.

Assessment of the Level of Awareness and Degree of Implementation of Central Line Bundles for Prevention of Central Line-associated Blood Stream Infection: A Questionnaire-based Observational Study.

The objective of this study was to assess the extent of knowledge and application of central line bundles in the intensive care unit (ICU) of a tertiary care hospital for the purpose of avoiding central line-associated bloodstream infections (CLABSI). This assessment was conducted through the use of a questionnaire. A cross-sectional study was conducted in the ICU, involving doctors and nurses. The study was observational in nature. The study employed a methodical validated questionnaire to evaluate the level of knowledge, attitude, and practice of central line bundles for the prevention of central line-associated bloodstream infections (CLABSI). The questionnaire was designed using preexisting awareness surveillance systems, infection control measures, and patient care practices that were specifically relevant to CLABSIs in the ICU. The data were analyzed utilizing SPSS. The research involved a total of 93 healthcare professionals, consisting of 67 physicians and 26 nurses. The mean knowledge score among participants was 82%, with higher scores reported in individuals who had training in central line bundles. Healthcare professionals exhibited robust compliance with hand cleanliness, antiseptic skin preparation prior to insertion, aseptic draping of the patient, utilization of utmost sterile barriers, verification of central venous catheter (CVC) tip placement using chest X-ray or fluoroscopy, and preservation of a sterile environment. The study emphasized the significance of training in enhancing understanding and adherence to central line bundling protocols in ICUs. Participants exhibited a high level of knowledge and commitment to recommended practices, indicating that this training can have a favorable effect on CLABSI rates. Singh S, Sharma A, Dhawan M, Sharma SP. Assessment of the Level of Awareness and Degree of Implementation of Central Line bundles for Prevention of Central Line-associated Blood Stream Infection: A Questionnaire-based Observational Study. Indian J Crit Care Med 2024;28(9):847-853.

Antiseptic skin preparation and surgical site infection: time to re-evaluate surveillance and the evidence?

Antiseptic skin preparation and surgical site infection: time to re-evaluate surveillance and the evidence?

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

Pregnancy with bacterial vaginosis (BV) is accompanied by a high risk of various obstetric and perinatal complications, including miscarriage, preterm birth, placental dysfunction, premature rupture of membranes, chorionamnionitis, polyhydramnios, etc. Screening for BV is carried out in the first half of pregnancy during the registration of a woman, however, taking into account the gestational age, many drugs with antimicrobial and antiseptic effects are categorically contraindicated, as they have an embryo- and fetotoxic effect.Timely detection and correction of microbiocenosis disorders of the birth canal is an extremely important element to prevent a number of obstetric and perinatal complications. A balanced approach in the treatment of vaginal dysbiosis consists in the use of modern combined antiseptic preparations for local treatment, which do not contain antibacterial components and are safe for use during pregnancy.The objective: to determine the effectiveness of the treatment of BV in primigravida women in the first half of pregnancy.Materials and methods. 126 primigravida women aged 18–35 years in the first half of pregnancy were examined during pregnancy registration. The participants were selected randomly.The main group included 36 primigravida women with a gestation period of up to 20 weeks with a diagnosis of BV according to the Amsel and Hay–Ison criteria, who were treated with a combined antiseptic drug (chlorhexidine and chlorophyllipt) – suppository vaginally twice a day, the course of treatment – 5 days. The control group included 30 primigravida women with a gestational age of up to 20 weeks with vaginal normocenosis.For all women the pH of vaginal secretions was determined, followed by microscopy of a native smear, stained according to Gram, and a cultural study was performed. Adherence to the Amsel criteria was also determined, followed by evaluation by the Hay–Ison criteria. The clinical effect was evaluated according to clinical examination data before and on the 6th day of treatment with a combined antiseptic drug (chlorhexidine and chlorophyllipt) using bacterioscopic and bacteriological methods.Results. A normal pH was observed only in every fifth part of examined pregnant woman (28 women – 22.2%), while in the rest patients the acidity of the vaginal environment was not normal. Normocenosis was observed only among 1/3 of primigravida women (37 women – 29.4%). A third of the patients were diagnosed with BV (36 women - 28.6%), every fifth pregnant woman – vulvovaginal candidiasis (28 women - 22.2%).In healthy pregnant women (control group, n=30), the main component of the microbiocenosis was Lactobacillus spp. with a small content of facultatively anaerobic microorganisms. In the main group Atopobium vaginae (38.9%), Gardnerella vaginalis (33.3%), Prevotella bivia (27.8%), Candida spp. (22.2%), as well as Lactobacillus spp. in low titers were dominated. Before the treatment all 36 pregnant women of the main group corresponded to the 3rd type according to the Hay–Ison criteria with the dominance of Gardnerella vaginalis and/or Mobiluncus morphotypes and a small number or complete absence of lactobacilli, which served as the basis for establishing the diagnosis of BV. After treatment type 1 (94.4%) was found in 34 pregnant women, and type 2 (5.6%) – in 2 pregnant women.The results of the microbiological study indicate the normalization of the content of the biotope with the predominance of Lactobacillus spp. in women of the main group, in whom the indicators were similar to the control group.Conclusions. Since pregnancy with BV is accompanied by a high risk of obstetric and perinatal complications, the premorbid background of which is laid already in the first half of pregnancy, there is an urgent need to carry out the birth canal sanitation. The drugs of choice for the BV in the first half of pregnancy are local combined agents of a wide spectrum of action.A universal antiseptic with an anti-inflammatory effect, which includes two components – chlorhexidine and chlorophyllipt, fully meets the recommendations for efficiency and safety and can be used for the BV in the first half of pregnancy.

Antiseptic and hygienic preparation of patients for ear surgery with an endaural approach

Introduction. Optimization of preoperative preparation protocols in otosurgery can reduce intraand postoperative infectious complications, improve surgical outcomes, which is important for the rehabilitation of patients with ear diseases.Aim. To determine the effectiveness of antiseptic and hygienic preoperative preparation of the surgical field during endaural otosurgical interventions.Materials and methods. The randomized study included 183 patients who underwent surgery via the endaural approach. The first part of the study evaluated the effect of 10% povidone-iodine solution treatment on the skin microbiome; the second part evaluated the need for ear canal depilation and before surgery and compared the methods.Results. Examination of skin microbiota of the external auditory canal in 85% revealed the growth of microorganisms:Staphylococcus – 115 (85.5%), fungal growth – 6 (4.4%), Corynebacterium – 8 (5.9%), etc. Microbial growth was not detected in 15%. Antiseptic treatment with 10% Povidone-iodine solution with endaural access reduces the degree of contamination and suppresses the growth of microorganisms in more than one third of patients. Inflammatory changes of the postoperative wound correspond to the degree of inflammation IA in both control and study groups. After depilation, visualization was assessed as optimal in 100% of cases and no inflammatory reactions were found. Average depilation time with scissors 113 sec, with an ear trimmer 32 sec.Conclusions. Preoperative antiseptic preparation reduces microbial contamination of the skin via endaural access, with no significant impact on wound healing process in the postoperative period. Depilation improved the view of the operative field in 100% of cases. Depilation with an ear trimmer is 3.5 times faster than with scissors.

Vaginal antiseptic preparation at the time of hysterectomy: a systematic review and meta-analysis

Vaginal antiseptic preparation at the time of hysterectomy: a systematic review and meta-analysis

Formulasi Antibakteri Mouthwash Ekstrak Etanol Daun Kirinyuh (Chromolaena odorata (L.) R.M.King & H.Rob.) Pada Bakteri Streptococcus mutans STCC 31987

Kirinyuh leaves (Chromolaeina odorata (L.) R.M.King &; H.Rob.) contain secondary metabolites in the form of flavonoids, saponins, steiroids, tannins that can inhibit the growth of antibacterial growth. Based or its antibacterial properties, kirinyuh leaf extract can be developed into mouthwash to prevent dental plaque. The purpose of this study was to determine the physical stability test of the kirinyuh leaf ethanol extract mouthwash preparation and to determine the antibacterial activity of the kirinyuh leaf ethanol extract against Streptococcus mutans ATCC 31987 bacteria, so that a formulation of the kirinyuh leaf ethanol extract mouthwash preparation could be made. Mouthwash is an antiseptic preparation that is used to clean the oral cavity and is used by gargling. The extraction used was remaceration method with 70% ethanol solvent, made in various extracts with concentrations of 10%, 20%, 30%. Further evaluation of the preparation includes : organoleptic test, pH test, viscosity test. The results of the One Way ANOVA analysis showed that there was no significant difference in the pH test, viscosity test with a p>0,05 value. Organoleptic test during 6 cycles of storage in a stable state during storage. The results showed that the ethanol extract of kirinyuh leaf mouthwash was able to inhibit the growth of Streptococcus mutans bacteria, namely in F1 the weak category was 2.43±0.81 mm, F2 was 10.21±3.56 mm the strong categori, F3 was 13.38±2.72 mm strong category.
 
 Keywords : Antibacterial, Kirinyuh leaves, Mouthwash

Optimal antiseptic skin preparation agents for minimizing surgical site infection following surgery: cost and cost-effectiveness analysis.

The application of antiseptic skin agents prior to incision minimizes the rate of surgical site infection. Despite their ubiquity, the optimal skin preparation agent remains uncertain. A retrospective economic analysis was conducted to complement the results from the NEWSkin Prep trial which prospectively compared three preparation agents. A cost and cost-effectiveness analysis was performed from a healthcare service perspective to compare chlorhexidine with 70% ethanol, and aqueous povidone-iodine, against povidone-iodine with 70% ethanol. Resource use estimates accounted for hospital admissions, readmissions associated with surgical site infection, outpatient and general practitioner attendances, visits from community nurses and therapeutic consumables. The measure of effectiveness comprised the net difference in number of patients with surgical site infections per 1000 patients. Costs were compared using a two-sample Welch's t-test. Deterministic and probabilistic sensitivity analyses were performed to evaluate the incremental cost-effectiveness ratio. The null hypothesis that the mean costs for the trial arms were significantly different was not rejected (Welch's t-test P value: 0.771 for chlorhexidine with 70% ethanol against povidone-iodine with 70% ethanol; and 0.955 for aqueous povidone-iodine against povidone-iodine with 70% ethanol). Based on bootstrap averages, the chlorhexidine with 70% ethanol intervention generated 8.0 fewer surgical site infections per 1000 patients and net cost savings of €151,698 (Euros) per 1000 patients compared with povidone-iodine with 70% ethanol, and aqueous povidone-iodine produced a net cost saving of €37,494 per 1000 patients but generated an additional 11.6 surgical site infections per 1000 patients compared with povidone-iodine with 70% ethanol. The comparison of chlorhexidine with 70% ethanol to povidone-iodine with 70% ethanol was sensitive to the inclusion of cost outliers, while the comparison of aqueous povidone-iodine to povidone-iodine with 70% ethanol was sensitive to the estimated cost per surgical site infection. Based on the outcomes from the NEWSkin Prep study, this economic analysis found no definitive evidence in favour of any one of the study comparators. Future model-based economic analyses of alternative skin preparations should critically address the quality of evidence and integrate the results from the NEWSkin Prep study.

Device-related infection and mortality in patients with chronic kidney disease receiving cardiac implantable electronic devices: a propensity score-matched cohort study.

Chronic kidney disease (CKD) was reported to be a risk factor of cardiac implantable electronic device (CIED) infection. The application of bundled skin antiseptic preparation before CIED implantation decreased the risk of CIED infection, even in patients undergoing complex procedures. However, the effect of bundled skin antiseptic preparation to prevent CIED infection in patients with CKD was not tested. Between July 2012 and December 2019, 1668 patients receiving CIEDs comprised this retrospective cohort study and were categorized into two groups by the diagnosis of CKD: group with CKD (n = 750, 45%) and group without CKD (n = 918, 55%). The primary outcome was clinical CIED infection, including major and minor infection, and the secondary outcomes were cardiovascular mortality and all-cause mortality. Propensity score matching (PSM) was applied to reduce selection bias between the study groups. During a 4-year follow-up period, 30 patients (1.8%) had a CIED infection. After PSM, the incidence of CIED infection was similar between the patients with CKD and without CKD (1.0% vs. 1.8%). The incidences of cardiovascular mortality and all-cause mortality were higher in patients with CKD compared to patients without CKD (6.5% vs. 3.0%, P = 0.009; 22.8% vs. 11.8%, P < 0.001, respectively). The incidence of clinical CIED infection in patients with CKD was as lower as in patients without CKD after applying the bundled skin antiseptic preparation strategy. The cumulative incidences of cardiovascular mortality and all-cause mortality were significantly higher in the matched CIED recipients with CKD compared to the matched cohort without CKD.

EFEKTIFITAS PREPARASI KULIT MENGGUNAKAN KLORHEXIDIN 7,5% SETRIMID 15%-POVIDON IODIN 10% DAN POVIDON IODIN 10%-ALKOHOL 70% TERHADAP INFEKSI LUKA OPERASI SEKSIO SESAREA DI RSUD DR. HARYOTO LUMAJANG

Surgical wound infections are the second most common cause of nosocomial infections and have high morbidity and mortality rates. The use of antiseptic skin preparations is effective in preventing surgical wound infections. There is still insufficient evidence to evaluate the type, concentration and method of use of antiseptic agents for skin preparation in cesarean section. The aim of the study was to determine the effectiveness of skin preparation using chlorhexidine 7.5%, cetrimide 15%-povidone iodine 10% and povidone iodine 10%-alcohol 70% against Wound Infections for Caesarean Section Operations in RSUD Dr. Haryoto Lumajang.&#x0D; The research design used is quantitative research with a quasi-experimental approach, post test only-control group design. The population in this study were patients who underwent cesarean section at RSUD Dr. Haryoto Lumajangl. The sample was selected by accidental sampling from 27 February 2023 to 25 March 2023, and 66 respondents were found who met the inclusion and exclusion criteria. The samples were divided into 2 groups: the test group (33 samples) received a combination skin preparation of 7.5% chlorhexidine, setrimide 15% - 10% povidone iodine and the control group (33 samples) received a skin preparation combination of 10% povidone iodine - 70% alcohol . Observation of the surgical wound was carried out on day 3 and day 10.&#x0D; The results of this study indicated that there was no incidence of surgical wound infection on the third day. Surgical wound infections on the 10th day in the 7.5% chlorhexidine skin preparation group, setrimide 15% - 10% povidone iodine by 2 respondents and in the 10% povidone iodine skin preparation group - alcohol by 4 respondents. But statistically it was not significantly different from the value of p = 0.395, meaning that Ho was accepted and Ha was rejected, so there was no significant difference between skin preparation using chlorhexidine 7.5% setrimide 15% - 10% povidone iodine and 10% povidone iodine - 70% alcohol on the Incidence of Wound Infection by Caesarean Section at RSUD Dr. Haryoto Lumajang.&#x0D; With the difference in the incidence of surgical wound infection, it can be considered and an alternative for Dr. Haryoto Lumajang to use skin preparation using 7.5% chlorhexidine, 15% setrimide-10% povidone iodine&#x0D; Keywords: Surgical wound infection, skin preparation, chlorhexidine, povidone iodine, alcohol, cesarean section.

Planar Chromatography as a Method for the Analytical Control of Composite Pharmaceutical Preparations Based on N-Vinylamides

Planar chromatography is used to develop methods for the analytical control of processes of the synthesis of biomedical polymers and their complexes with biologically active substances, which made it possible to create a number of long-acting antiviral, antitumor, antimicrobial, and antiseptic preparations.

In vitro evaluation of antimicrobial and anti-biofilm properties of antiseptics against multidrug resistant clinical Escherichia coli strains, isolated from combat wounds

The necessity for the investigation of novel approaches and strategies for the treatment of multidrug-resistant E. coli related infections becomes more and more essential. Purpose - to investigate and compare the level of antimicrobial and anti-biofilm activity of antiseptic preparations against MDR clinical isolates of E. coli. Materials and methods. In vitro effectiveness of modern antiseptics; octenidine 0.1% (OCT), polyhexanide 0.1% (PHMB), chlorhexidine 0.5% (CHG), miramistin 0.01% (MRM), decamethoxine 0.1% 0.02% (DCM), povidone-iodine 10% (PVP-I), was determined against forty-six polyresistant clinical strains of E. coli. MIC, MBC were found by standard methods, the value of which was interpreted as a bacteriostatic and bactericidal index of antiseptic activity (BS IAA and BC IAA). The effect of antiseptics on the immature biofilm was modelled using the Christensen test. Results. MIC and MBC values were the lowest in DCM and OCT. The highest values of the antiseptic activity index (IAA&gt;4) were determined for the antiseptics PHMB 0.1%, OCT 0.1% and DCM 0.1%. It was found that the feasibility of using MRM at a concentration of 0.01% is questionable as the BS IAA is above the threshold value, while the BC IAA is not. The effectiveness of PVP-I 1% against MDR E. coli was found insufficient. Sub-bacteriostatic concentrations of DCM, CHG, and PHMB reliably inhibited the formation of E. coli biofilms within 24 hours. MRM and PVP-I in sub-bacteriostatic concentrations stimulated biofilm formation. Conclusions. Based on the analysis of all conducted studies, 0.1% and 0.02% DCM, 0.05% CHG, 0.1% OCT, 0.1% PHMB, 10% and 2% PVP-I are the most active against MDR clinical isolates of E. coli. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Ozonated Oil in Liposome Eyedrops Reduces the Formation of Biofilm, Selection of Antibiotic-Resistant Bacteria, and Adhesion of Bacteria to Human Corneal Cells.

The recent attention to the risk of potential permanent eye damage triggered by ocular infections has been leading to a deeper investigation of the current antimicrobials. An antimicrobial agent used in ophthalmology should possess the following characteristics: a broad antimicrobial spectrum, prompt action even in the presence of organic matter, and nontoxicity. The objective of this study is to compare the antimicrobial efficacy of widely used ophthalmic antiseptics containing povidone-iodine, chlorhexidine, and liposomes containing ozonated sunflower oil. We determined the minimum inhibitory concentration (MIC) on various microbial strains: Staphylococcus aureus (ATCC 6538), methicillin-resistant Staphylococcus aureus (ATCC 33591), Staphylococcus epidermidis (ATCC 12228), Pseudomonas aeruginosa (ATCC 9027), and Escherichia coli (ATCC 873). Furthermore, we assessed its efficacy in controlling antibiotic resistance, biofilm formation, and bacterial adhesion. All three antiseptic ophthalmic preparations showed significant anti-microbicidal and anti-biofilm activity, with the liposomes containing ozonated sunflower oil with the highest ability to control antibiotic resistance and bacteria adhesion to human corneal cells.

Effect of making skin incision with electrocautery on positive Cutibacterium acnes culture rates in shoulder arthroplasty: a prospective randomized clinical trial

Cutibacterium acnes remains the most commonly detected organism in shoulder arthroplasty. C. acnes infection is thought to occur during shoulder arthroplasty through contamination of the surgical field with C. acnes from the incised dermis. The purpose of this study was to examine whether using electrocautery for making skin incisions would decrease C. acnes culture rates at the incised dermis compared to using scalpels during shoulder arthroplasty. Patients undergoing primary shoulder arthroplasty were randomized into 2 groups, Electrocautery vs. Scalpel incision group. All patients received a standard preoperative antiseptic preparation including chlorhexidine gluconate showers, intravenous antibiotic administration, and topical application of hydrogen peroxide, povidone iodine, isopropyl alcohol, and DuraPrep. Cultures were obtained from the incised dermal edge immediately after skin incision and later from surgeon's gloves and forceps immediately prior to humeral component implantation. The primary outcome was positive C. acnes culture rates compared between the groups. A total of 64 patients (32 in each group) were enrolled. There were 24 males in each group. Regarding dermis cultures, 10 patients (31%) in the Scalpel group were positive with 8 of them positive for C. acnes, whereas no patients in the Electrocautery group were positive (p < 0.001). Regarding glove cultures, the Electrocautery group had 8 patients positive C. acnes, while the Scalpel group had 8 (p = 0.777). Regarding forceps cultures, the Electrocautery group had 4 patients positive for C. acnes, and the Scalpel group had 6 (p = 0.491). All positive cultures were exclusively from male patients. There were no wound complications or infection in the Electrocautery group while the Scalpel group had one acute postoperative infection. Making skin incisions using electrocautery resulted in zero C. acnes culture at the incised dermis, suggesting its potential effect against C. acnes. However, despite this initial antibacterial effect, C. acnes still appeared on surgeon's gloves and forceps during surgery of male patients. All positive cultures were from male patients, suggesting that the source of C. acnes was specifically related to the male body. While the study hypothesis was supported by the results, the present study also raises new questions and calls for further research.

ANALYSIS OF THE EFFICIENCY OF THE SOUND IMPACT ON THE MICRO AND MICROCHANNEL SYSTEM OF THE TOOTH ROOT. LABORATORY STUDY

The effectiveness of antiseptic action in endodontics depends on additional methods of dynamic action on the irrigation solution. The treatment of chronic apical periodontitis is directly related to the effect of the antiseptic preparation on the biofilm in the system of micro and macro channels of the tooth root. Current data show significant difficulty in biofilm elimination. This study shows the significant effectiveness of the combined administration of an antimicrobial drug with the use of sound activation

A survey of Asian Eye Institutions on perioperative antibiotic prophylaxis in cataract surgery

PurposeTo determine current institutional practice patterns for the use of perioperative antibiotics and other measures to prevent infection after cataract surgery in Asia.MethodsAn online survey-based study of leading eye institutions in China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, South Korea, Taiwan, Thailand and Vietnam was conducted. The survey was administered to 26 representative key opinion leaders from prominent tertiary eye institutions that are also national academic teaching institutions in Asia. Survey responses were collated and anonymized during analysis.ResultsAll surveyed institutions used povidone iodine for the preoperative antiseptic preparation of the eye, with notable variations in the concentration of povidone iodine used for conjunctival sac instillation. Preoperative topical antibiotics were prescribed by 61.5% and 69.2% of institutions in low-risk and high-risk cases, respectively. Regarding the use of intra-operative antibiotics, 60.0% and 66.7% of institutions administered intracameral antibiotics in low-risk and high-risk patients, respectively. Postoperative topical antibiotics use patterns were generally very similar in low-risk and high-risk patients. Over half of the institutions (52.2% and 68.0% in low-risk and high-risk patients, respectively) also indicated prolonged postoperative use of topical antibiotics (> 2 weeks). Not all surveyed institutions had established policies/protocols for perioperative antibiotic use in cataract surgery, endophthalmitis surveillance, and/or a monitoring program for emerging antimicrobial resistance.ConclusionThere are variations in antimicrobial prophylaxis approaches to preoperative, intra-operative and postoperative regimens in cataract surgery in Asia. More evidence-based research is needed to support the development of detailed guidelines for perioperative antibiotic prophylaxis to reduce postoperative infections.

Improving Surgical Safety in Living Donor Renal Transplantation With Antiseptic Skin Preparation, Bladder Irrigation, Corner-Saving Vascular Anastomosis, DJ Stenting, and Extravesical Ureteroneocystostomy Modifications: A Comprehensive Approach.

Introduction The antiseptic skin preparation, bladder irrigation, corner-saving vascular anastomosis, DJ stenting, and extravesical ureteroneocystostomy (ABCDE) approach encompasses a range of modifications applied during different stages of the surgical procedure in renal transplantation. These modifications include the following: A, antiseptic skin preparation sequentially with cetrimide 3.35%, chlorhexidine scrub 4%, spirit, and povidone-iodine 10%; B, bladder irrigation with amikacin and betadine solution;C, corner-saving end-to-side vascular anastomosis; D, DJ stenting with early postoperative removal within three weeks; and E, extravesical ureteroneocystostomy using our institute's modified Lich-Gregoir technique. Methods This prospective observational study was conducted at our institution between March 2021 and May 2023. Data were collected from the patients' medical records and analyzed using Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY, USA). Statistical tests, including t-test, Mann-Whitney test, chi-square test, and Fisher's exact test, were used for analysis. The study assessed various recipient, donor, intraoperative, and post-transplant factors, as well as surgical complications and stent-related factors. Results Out of 72 renal transplantations, 12 (16.6%) had the followingsurgical complications: urinary(n= 4; 5.5%), wound-related (n= 3; 4.1%), andlymphocele(n= 5; 6.9%). The most common complications werelymphocele(n= 5; 6.9%) and urinary leak (n= 4; 5.5%). Surgical complications were more common in male recipients (91.6% versus 8.3%), as well as in recipients with longer dialysis duration (24 ± 17 versus 11.0 ± 7 months) and had extended hospitalization time (16.4 ± 8.6 versus 8.0 ± 2.9 days) (p < 0.05). Wound infectioncorrelated with longer surgeries (>300 minutes) and other complications. Lymphocele patients had higher drain output (>500 mL) on day 1 and longer hospital stays (>15 days). Urinary tract infections (UTIs) were linked to dialysis duration (>24 months), diabetes, and longer indwelling times of DJ stents and urinary catheters. Early DJ stent removal (<3 weeks) reduced UTI incidence and symptoms (p < 0.05). All complications were categorized as minor (3a or less), according to the Clavien-Dindo classification. Conclusion The modified ABCDE surgical approachin renal transplantation decreased the complications, showing favorable outcomes compared to those in the literature.

Effectiveness of chlorhexidine diacetate and povidone-iodine in antiseptic preparation of the canine external ear canal prior to total ear canal ablation with bulla osteotomy procedure: A preliminary study.

This article is a preliminary study to compare the ability of 0.05% chlorhexidine diacetate (CD) and 1% povidone-iodine (PI) solutions to reduce bacterial contamination on the canine external ear canal during initial patient preparation and comparison of the incidence of immediate tissue reactions. The study is a multi-institutional, randomised, clinical prospective study. Dogs (n = 19) undergoing total ear canal ablation with bulla osteotomy (TECABO). The external ear of each dog was cleaned with the assigned antiseptic solution. Culture of the ear was performed by standard techniques to semi-quantitatively evaluate bacterial growth and to identify bacterial organisms pre- and post-antiseptic use. Both antiseptic groups showed a significant reduction in bacterial growth score (BGS) between pre- and post-antiseptic use (CD p = 0.009, PI p = 0.005). There was no difference in the reduction of BGS between CD and PI solutions (p = 0.53). Minor adverse skin reactions occurred in 25% of cases. There was no significant difference in the occurrence of adverse skin reactions between antiseptics (p = 0.63). CD and PI were similarly able to decrease the number of bacteria on the external ear following initial preparation. No difference in the incidence of adverse tissue reactions was found. Properly diluted aqueous formulations of either antiseptic may be used for safe preparation limited to the external ear canal of dogs. Additional studies evaluating outcomes such as duration of bacterial inhibition and incidence of surgical site infections are needed to fully elucidate differences between CD and PI antiseptics prior to TECABO.

Dynamics of free radical processes in the oral fluid of patients with chronic recurrent aphthous stomatitis at the first stage of therapy

Chronic recurrent aphthous stomatitis (CRAS) is a disease of the oral mucosa, characterized by the appearance of specific round aphthous forms with hyperemic corolla, covered with grayish-yellow plaque against the background of inflamed mucous membrane, which violates the oxidative homeostasis of oral fluid and the body as a whole.The aim of our study was to reveal the dynamics of free radical processes in oral fluid of patients with chronic recurrent aphthous stomatitis on the background of the first stage of antiseptic therapy with analgesics in order to determine the optimal treatment tactics for this condition. In order to achieve the set objective we had to solve the following tasks: to evaluate the functional activity of free radical processes in the oral liquid of patients with CPAS on the background of antiseptics (chlorhexidine, octenisept, furacilin, myramistine) and anaesthetic (Camistad gel) application for 7 days.Materials and Methods. During the study the oral fluid of 120 people diagnosed with CPPS was studied, divided into 4 groups equally: Group 1 – control, patients used the antiseptic chlorhexidine for gargling; Group 2 – patients with CPPS therapy with octenisept; Group 3 – patients with CPPS therapy with furacilin; Group 4 – patients with CPPS therapy with miramistine. For pain relief, patients in all groups used Kamistad gel. Analysis of free radical processes in oral fluid of patients was carried out before the study and on the 7th day of therapy by determining products of oxidative modification of biomolecules on the basis of quantitative evaluation of stained complex with thiobarbituric acid (TBA), maximal flash (MVHL) and area (PCL) of H2O2-induced luminol-dependent chemiluminescence using LT-01 chemiluminometer ("Horos" "Joint Venture Soviet-Swedish Company"). Concentration of diene conjugates and malonic dialdehyde was also determined to estimate enzymatic part of oxidative homeostasis.Results of the study. Results of the researches permit to conclude that at chronic recurrent aphthous stomatitis enzymatic activity of an oral liquid changes. According to the presented data the initial values of concentration of TBK-RP, maximal flash of oral chemiluminescence, area of oral chemiluminescence and concentration of MDA and DC in the control group and three experimental groups reliably differ from the data received on the 7th day of the research. Significant decrease of the studied indexes of oral liquid testifies to the efficiency of the first stage of therapy of aphthous stomatitis by antiseptic preparations and decrease of intensity of oxidative processes in oral liquid. Of all the proposed antiseptics the best efficiency is demonstrated by octenisept, reliably worse are chlorhexidine and myramistine and the least effective in the therapy of CPAS is furacilin.Conclusions: treatment of CPAS with Octenisept in combination with Camistad gel is the most effective in restoration of the disturbed oxilite.