Randomized controlled trial of the effectiveness of chlorhexidine showers before elective plastic surgical procedures

This randomized controlled trial was designed to assess the effect of preoperative chlorhexidine showers on skin colonization and postoperative infection rates associated with plastic surgical procedures involving the trunk. Chlorhexidine showers were effective in reducing skin colonization with coagulase-negative staphylococci and yeasts, but there was no difference in postoperative infection rates.

Dressing Wear Time after Breast Reconstruction: A Randomized Clinical Trial

Background

The evidence to support dressing standards for breast surgery wounds is empiric and scarce.

Objective

This two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions.

Methods

A total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100). SSIs were defined and classified according to criteria from the Centers for Disease Control and Prevention. Samples collected before placing the dressing and after 1 day (group I) and 6 days (both groups) were cultured for skin colonization assessments. Patients preferences and perceptions with regard to safety, comfort and convenience were recorded and analyzed.

Results

A total of 186 patients completed the follow-up. The global SSI rate was 4.5%. Six patients in group I and three in group II had SSI (p = 0.497). Before dressing, the groups were similar with regard to skin colonization. At the sixth day, there was a higher colonization by coagulase-negative staphylococci in group I (p<0.0001). Patients preferred to keep dressing for six days (p<0.0001), and considered this a safer choice (p<0.05).

Conclusions

Despite group I had a higher skin colonization by coagulase-negative staphylococci on the sixth postoperative day, there was no difference in SSI rates. Patients preferred keeping dressing for six days and considered it a safer choice.

Trial Registration

ClinicalTrials.gov NCT01148823

Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial

BACKGROUND

One of the major risk variables for surgical site infection is wound management. Understanding infection risk factors for breast operations is essential in order to develop infection-prevention strategies and improve surgical outcomes. The aim of this trial is to assess the influence of dressing wear time on surgical site infection rates and skin colonization. Patients' perception at self-assessment will also be analyzed.

METHODS/DESIGN

This is a two-arm randomized controlled trial. Two hundred breast cancer patients undergoing immediate or delayed breast reconstruction will be prospectively enrolled. Patients will be randomly allocated to group I (dressing removed on postoperative day one) or group II (dressing removed on postoperative day six). Surgical site infections will be defined by standard criteria from the Centers for Disease Control and Prevention (CDC). Skin colonization will be assessed by culture of samples collected at predefined time points. Patients will score dressing wear time with regard to safety, comfort and convenience.

DISCUSSION

The evidence to support dressing standards for breast surgery wounds is empiric and scarce. CDC recommends protecting, with a sterile dressing for 24 to 48 hours postoperatively, a primarily closed incision, but there is no recommendation to cover this kind of incision beyond 48 hours, or on the appropriate time to shower or bathe with an uncovered incision. The results of the ongoing trial may support standard recommendations regarding dressing wear time after breast reconstruction.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: http://NCT01148823.

Prevalence of myocardium revascularization wound infections surgery

OBJECTIVE

To study the prevalence of wound infection on myocardial revascularization surgery stitches as well as the microorganisms Causing, predominant fri, acts and try to correlate it with the APACHE risk.

METHODS

A retrospective and transversal study, with analysis of the files of the 21 Patients with infected wounds myocardial revascularization operated Among 357 Patients Between the years of 2007 and 2009. Were the files checked on 2009.

RESULTS

There was in statistics Analyzing the Significance of the fri Patients. The average of Patients Were old aged and the prevalence is similar to the index found in literature, But There Are Variations about the microorganisms found all over the years.

CONCLUSION

Besides the raise of wound infections along the three years, the prevalence Kept stable, once the numbers of surgeries maid raised proportionately. Fri Significant is not a variable to the Occurrence of myocardium revascularizations wound infection. Old aged people are more predictable to this complication and the microorganism is Causing variable.

Tap Water has No Influence on Microbial Colonization of Skin Wounds in Rats

 The aim of this study was to investigate the influence of tap water on microbial colonization of skin wounds in rats.

METHODS

A cir- cular wound 2.4 cm in diameter was created on the back of 40 Wistar rats, which were randomly assigned to the control (n = 20) or study (n = 20) group. The wounds were cleansed daily using a sterile 0.9% sodium chloride solution (control group) or tap water (study group) for 6 days, following a standardized protocol. Sequential samples were collected for microbiological analysis every other day.

RESULTS

Microbial growth occurred in 49% of the samples from the control group and in 47% of the samples from the study group (P = 0.39). There was no significant difference in microbial growth between groups for the different culture media: thioglycolate (P = 0.20), mannitol salt agar (P = 0.53), blood agar (P = 0.61), eosin methylene blue agar (P = 0.51), and Sabouraud agar (P = 0.34). The following microorganisms were identified: Bacil- lus subtilis, Staphylococcus sp, Aureobasidium sp, Penicillium sp, and Cladosporium sp.

CONCLUSION

The use of tap water for cleansing skin wounds in rats had no effect on microbial colonization compared with the use of a sterile saline solution. .