Efficacy of Mechanical versus Non-Mechanical Sterile Preoperative Skin Preparation With Chlorhexidine Gluconate 4% Solution.

Abstract

OBJECTIVE: To compare the efficacy of sterile preoperative skin antisepsis using either a 5-minute mechanical preparation or 5-minute non-mechanical preparation with chlorhexidine gluconate 4% solution. STUDY DESIGN: Matched design, ANOVA. ANIMALS: Healthy adult Thoroughbred horses (n&#x2009;=&#x2009;30). METHODS: Each horse had both surgical preparation methods randomly assigned to identical sites on the left or right upper thigh. Prepared sites were sampled and cultured for bacteria after each preparation step. RESULTS: Mechanical and non-mechanical preparation techniques significantly reduced bacteria isolated from surface swab samples compared with samples taken from unprepared skin and after the preliminary rough prepared skin (P&#x2009;<&#x2009;0.05). No difference in the number of skin-associated bacteria was detected between the mechanical and non-mechanical sterile preoperative preparation techniques (P&#x2009;=&#x2009;0.77). Ten species of bacteria were identified by 16s PCR after final skin preparation. CONCLUSIONS: Pre-surgical skin preparation without repeated mechanical scrubbing using chlorhexidine gluconate 4% solution (total contact time, 225&#x2009;seconds) is effective in reducing bacterial counts.