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    Large variations in the practice patterns of surgical antiseptic preparation solutions in patients with open and closed extremity fractures: A cross-sectional survey

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    Author
    Jurado-Ruiz, M.
    Slobogean, G.P.
    Bzovsky, S.
    Date
    2018
    Journal
    Antimicrobial Resistance and Infection Control
    Publisher
    BioMed Central Ltd.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://dx.doi.org/10.1186/s13756-018-0440-z
    Abstract
    Background: Surgically-managed fractures, particularly open fractures, are associated with high rates of surgical site infections (SSIs). To reduce the risk of an SSI, orthopaedic surgeons routinely clean open fracture wounds in the emergency department (ED) and then apply a bandage to the open wound. Prior to the surgical incision, it is standard practice to prepare the fracture region with an antiseptic skin solution as an additional SSI prevention strategy. Multiple antiseptic solutions are available. Objectives: To explore the variation in practice patterns among orthopaedic surgeons regarding antiseptic solution use in the ED and antiseptic preparatory techniques for fracture surgery. Methods: We developed a 27-item survey and surveyed members of several orthopaedic associations. Results: Two hundred and-ten surveys were completed. 71.0% of respondents irrigate the open wound and skin in the ED, primarily with saline alone (59.7%) or iodine-based solutions (32.9%). 90.5% of responders indicated that they dress the open wound in the ED, with 41.0% applying a saline-soaked bandage and 33.7% applying an iodine-soaked dressing (33.7%). In their surgical preparation of open fractures, 41.0% of respondents used an iodine-based solution, 26.7% used a chlorhexidine gluconate (CHG)-based solution, and 31.4% used a combination of the two. In closed fractures, 43.8% of respondents used a CHG-based solution, 28.1% used an iodine-based solution, and 27.1% used a combination. Despite theoretical concerns about the use of alcohol in open wounds, 51.4% used alcohol-based solutions or alcohol alone during skin preparation of open fractures. Conclusions: A lack of consensus exists regarding use of antiseptic surgical preparation solutions for fractures. High-quality clinical research is needed to assess the effectiveness of different surgical antiseptic preparation solutions on patient outcomes in fracture populations. Copyright 2018 The Author(s).
    Keyword
    Antiseptic preparation
    Antiseptic solution
    Closed fracture
    Open fracture
    Surgical preparation
    Surgical site infection
    Survey
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85057450571&doi=10.1186%2fs13756-018-0440-z&partnerID=40&md5=9f5ed5e7692514da683a0df8f8e49f9e; http://hdl.handle.net/10713/9284
    ae974a485f413a2113503eed53cd6c53
    10.1186/s13756-018-0440-z
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