The two most widely administered antiseptic surgical scrub agents in dermatologic surgery are chlorhexidine and povidone-iodine. Povidone-iodine scrubs are composed of 7.5% to 10.0% povidone-iodine, typically in an aqueous or alcohol base, and are occasionally combined with detergent.
There are some things that you can do to decrease your risk of a surgical site infection, such as reducing the bacteria (“germs”) on your skin. You have been given some special disposable cloths moistened with 2% Chlorhexidine Gluconate (CHG) antiseptic solution to help prepare your skin for surgery.
This study found that the 2% CHG PC treatment led to a significantly greater log10 microbial count reduction in inguinal areas compared to the 4% CHG SP at all testing times (10 minutes, 30 minutes, 6 hours; P<0.05).
Povidone iodine topical is used on the skin to treat or prevent skin infection in minor cuts, scrapes, or burns. This medicine is also used in a medical setting to help prevent infection and promote healing in skin wounds, pressure sores, or surgical incisions.
Intraoperative measures primarily focus on decontamination of the skin and intraoperative wound irrigation using soap and antiseptics and are a simple, efficient, and cost-effective measure to reduce SSIs [10]. The most frequently used antiseptic is povidone-iodine (PVI), commonly applied as irrigation or a spray.
Chlorhexidine-alcohol was significantly more protective than povidone-iodine against both superficial incisional infections (4.2% vs. 8.6%, P=0.008) and deep incisional infections (1% vs. 3%, P=0.05) but not against organ-space infections (4.4% vs. 4.5%).
Chlorhexidine may cause staining and an increase in tartar (calculus) on your teeth. Brushing with a tartar-control toothpaste and flossing your teeth daily may help reduce this tartar build-up and staining.
What if I use too much? Chlorhexidine is usually a safe medicine if you follow the instructions that come with it. However, do not use more than the recommended dose. Speak to your doctor or a pharmacist now if you or your child has swallowed too much.
Chlorhexidine is ineffective against polioviruses and adenoviruses. The effectiveness against herpes viruses has not yet been established unequivocally. There is strong evidence that chlorhexidine is more effective than povidone-iodine for clean surgery.
Preoperative/Preadmission Skin Preparation:
On the day of surgery, gently wipe the skin with either an alcohol or chlorhexidine based solution (i.e. 70% isopropyl alcohol, chlorhexidine gluconate) in the preoperative area or in the operating room to provide a preliminary cleanse of the entire surgical field.
Alcohol-Based Solutions. Ethyl and isopropyl alcohol are 2 of the most effective antiseptic agents available. When used alone, alcohol is fast and short acting, has broad-spectrum antimicrobial activity, and is relatively inexpensive.
Apply an antibiotic cream or ointment, such as Aquaphor or Vaseline, to your incision site, and keep it covered with appropriate bandaging to prevent dirt, bacteria, and other irritants from entering the wound. A moist environment helps the cells to replicate and properly bond together to close up the incision faster.
Chlorhexidine should only be used on the skin. Do not swallow it or get it in the eyes, ears, mouth, or nose. Do not use it on the genital area (sex organs) or anal area. If it does get on these areas, rinse it off right away.
The main reason many clinicians dislike chlorhexidine is because of its side effects. We all know chlorhexidine stains teeth, and another common side effect is calculus buildup. Neither side effect is something you'd logically want for patients after their scalings, prophies, or surgeries.
Conclusions Saltwater rinses are as efficient as 0.12% chlorhexidine in reducing inflammation following minimal invasive periodontal surgery. Being an inexpensive and easily accessible option, it might be considered the mouth rinse of choice during the early stages of wound healing.
Consider using alternative antiseptics such as povidone-iodine, alcohols, benzalkonium chloride, benzethonium chloride, or parachlorometaxylenol (PCMX) when any previous allergy to chlorhexidine gluconate is documented or suspected.
Povidone-iodine (PVP-I), also known as iodopovidone, is an antiseptic used for skin disinfection before and after surgery. It may be used both to disinfect the hands of healthcare providers and the skin of the person they are caring for.
Chlorine dioxide, the active ingredient in OraCare rinse, has the power to kill the same bacteria as CHX, with the same substantivity while using less parts per million in comparison.
However, using chlorhexidine mouthwashes for longer than four weeks leads to tooth staining (requiring professional cleaning) and a build-up of tartar.
Although its toxicity level is higher than saline it is still recommended for cleansing and dressing of wounds (Sibbaldet al.; Morgan, 1999 and Rodeheaver, 1997). Chlorhexidine causes damage to new tissues and should not come in contact with the meninges and mucous membranes as this can cause permanent damage.
Chlorhexidine is a broad-spectrum biocide effective against Gram-positive bacteria, Gram-negative bacteria and fungi. Chlorhexidine inactivates microorganisms with a broader spectrum than other antimicrobials (e.g. antibiotics) and has a quicker kill rate than other antimicrobials (e.g. povidone-iodine).
Topical antiseptics are useful for reducing bacterial counts on intact skin in preparation for surgery. Povidone-iodine (Betadine) and chlorhexidine gluconate (Hibiclens) have emerged as the two agents of choice. However, antiseptics have been shown to be toxic to healing tissue, and should not be used on open wounds.
After ensuring that the affected area is clean and dry, apply a small amount of the solution or ointment. Doctors recommend using it one to three times a day at regular intervals. Betadine should not be used on deep, open wounds or severe burns. Prompt medical attention is recommended in such cases.
Once again, however, experts agree that Betadine is too harsh to put on a healing wound. Side effects include skin irritation, but if Betadine is used on large wounds it may cause kidney problems, high blood sodium, and metabolic acidosis to occur.
Salt water was as effective as chlorhexidine in reducing dental plaque (p = 0.19) and A. actinomycetemcomitans (p = 0.35) count and while chlorhexidine was superior against S. mutans (p = 0.001), L.