Title: A Comparative Study between Efficacies of Povidone-Iodine (10%) Solution versus Alcohol Based Solution Hygienium as Skin Antiseptic
Authors: Dr Mahendra Ekka, Dr Dulal K.Soren, Dr Malay Ku.Patel, Dr Sheela Ekka, Dr Sapan Ku.Jena, Dr Saurbh Agrawal
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.145
Abstract
Background and Objectives: Skin asepsis is a crucial measure for preventing infectious complications of central neuraxial block, i.e. meninigitis. The aim of this study was to comparative evaluatation of effectiveness of some conventional surgical antiseptic solutions and to identify the most effective one.
Material and Methods: Effectiveness of Hygenium was compared with Povidone-iodine (10% Betadine) as skin antiseptic prior to administration of central neuraxial block. Two rounds of sampling were conducted, one before application of antiseptic solution and the second after skin preparation with antiseptic solution. Colonies were counted after 48 hours of aerobic incubation at 37°C. All counts were conducted twice. Positive cultures were identified and their frequencies were compared. Data were summarized using descriptive statistical methods. Comparison of counts between groups was performed.
Results: Out of 131 samples, positive culture in Hygenium as compared to Povidone-iodine (4.6% v 6.2%) is statistically not significant showing equal efficacy. Staph. aureus, Staph epidermidis, Streptococcus, Diptheroids are most common organisms isolated in both the groups for testing the antiseptic efficacy.
Conclusions: Povidone-iodine and Hygenium are equally effective as antiseptic. Hygenium can preferably used in situations where lesser time is required for preparation of skin prior to administration of central neuraxial block and when patient positioning is difficult.
Keywords: Povidone-iodine, Alcohol-based Solutions, Hygienium, Skin asepsis,
References
- Royal College of Anaesthetists. Major complications of central neuraxial block in the United Kingdom. Report and findings of the 3rd National Audit Project of the Royal College of Anaesthetists, 2009. http://www.rcoa.ac.uk/node/4207 (accessed 06/10/13).
- Horlocker TT, Birnbach DJ, Connis RT, et al. Practice advisory for the prevention, diagnosis, and management of infectious complications associated with neuraxial techniques. A report by the American Society of Anesthesiologists Task Force on infectious complications associated with neuraxial techniques. Anesthesiology 2010; 112: 530-45.
- Hebl JR. The importance and implications of aseptic techniques during regional anesthesia.Regional Anesthesia and Pain Medicine 2006; 31: 311-23.
- Fleischer W, Reimer K. Povidone‑iodine in antisepsis – State of the art. Dermatology 1997;195:3‑
- Kadam R, Sharma C, Chhallani A, Yadav S. A comparative study between the efficacies of betadine scrub (10%) versus alcohol based hand rub in preoperative hand disinfection. Int J Res Med Sci 2016;4:5141-3.
- Sato S, Sakuragi T, Dan K. Human skin flora as a potential source of epidural abscess. Anesthesiology 1996; 85:1276-82.
- Kareem SAMA, Mahmood AA, Husein ZR. Ibn Al-Haithem Teaching Eye Hospital, Baghdad, Iraq. Alcohol Based Handrub versus Traditional Hand Scrub as Surgical hand Disinfection in a Tertiary Eye Teaching Hospital. J ClinEsp Ophthalmology. 2014;5(3): doi:10.4172/2155-9570.1000340.
- Kulkarni AP, Awode RM. A prospective randomised trial to compare the efficacy of povidone-iodine 10% and chlorhexidine 2% for skin disinfection.Indian J Anaesth. 2013;57(3):270-5.
- Bradbury CL, Hale B, Mather I, Suri I. Skin disinfection before spinal anaesthesia for caesarean section: a survey of UK practice. International Journal of Obstetric Anesthesia 2011; 20; 101-2.
- Checketts MR. Wash and go – but with what?Skin antiseptic solutions for central neuraxial block.Anaesthesia2012; 67: 819-22.
- Rotter ML: Arguments for the alcoholic hand disinfection. Journal of Hospital Infection 2001, 48:S4-S8.
- Boyce JM, Pittet D: Guideline for hand hygiene in health-care settings. Recommendations of the healthcare infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force. MMWR - Morbidity & Mortality Weekly Report 2002, 51:1-45.
- Kampf G, Kramer A: Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clinical Microbiology Reviews 2004, 17:863-893.
- Rotter ML: Hand washing and hand disinfection. In Hospital epidemiology and infection control 2nd edition.Edited by: Mayhall CG. Philadelphia, Lippincott Williams & Wilkins; 1999:1339-1355.
- Kampf G, Kapella M: Suitability of Sterillium Gel for surgical hand disinfection. Journal of Hospital Infection 2003, 54:222-225.