O que usar no preparo cirúrgico da pele: povidona-iodo ou clorexidina? / What to use in preoperative skin preparation: povidone-iodine or chlorhexidine? / ¿Qué usar en la preparación quirúrgica de la piel: povidona-iodo o clorhexidina?

Objetivo: Discorrer sobre a eficácia do gluconato de clorexidina e do povidona-iodo em soluções aquosas ou alcoólicas na redução de infecções do sítio cirúrgico e na contagem bacteriana da pele, no preparo pré-operatório do paciente. Método: Estudo de reflexão acerca do melhor antisséptico a ser usado no preparo cirúrgico da pele. Resultados: Verificou-se que tanto a clorexidina quanto o povidona-iodo são igualmente seguros e efetivos e que os manuais de boas práticas internacionais têm recomendado a sua utilização em soluções alcoólicas. Observou-se uma tendência na indicação da clorexidina alcoólica e a emergência de estudos que têm avaliado o uso sequencial ou concomitante da clorexidina e do povidona-iodo com resultados favoráveis a essa prática. Conclusão: Há uma tendência mundial mais favorável ao uso da clorexidina alcoólica em detrimento ao povidona-iodo. Contudo, a decisão pelo melhor agente antisséptico deve considerar cada caso clínico, (contra) indicações e situação

Objective: To discuss the efficacy of chlorhexidine gluconate and povidone-iodine in aqueous or alcoholic solutions in reducing surgical site infections and skin bacterial counts in the preoperative preparation of the patient. Method: Reflective study about the best antiseptic to use in preoperative skin preparation. Results: We found that chlorhexidine and povidone-iodine are equally safe and effective and that international guidelines for good practices have recommended their use in alcoholic solutions. We observed a trend in recommending alcoholic chlorhexidine and an emergence of studies that have evaluated the sequential or concurrent use of chlorhexidine and povidone-iodine with favorable results for this practice. Conclusion: There is a global trend that favors the use of alcoholic chlorhexidine over povidone-iodine. However, the decision about the best antiseptic agent to useshould be based on each clinical case, (contra)indications, and situation

Objetivo: Discutir sobre la eficacia del gluconato de clorhexidina y del povidona-yodo en soluciones acuosas o alcohólicas en la reducción de infecciones del sitio quirúrgico y en el recuento bacteriano de la piel en la preparación preoperatoria del paciente. Método: Estudio de reflexión acerca del mejor antiséptico a utilizarse en la preparación quirúrgica de la piel. Resultados: Se ha comprobado que tanto la clorhexidina como el povidona yodo son igualmente seguros y efectivos y que los manuales de buenas prácticas internacionales han recomendado su utilización en soluciones alcohólicas. Se observó una tendencia en la indicación de la clorhexidina alcohólica y la emergencia de estudios que han evaluado el uso secuencial o concomitante de la clorhexidina y del povidona-yodo con resultados favorables a esa práctica. Conclusión: Hay una tendencia mundial más favorable al uso de la clorhexidina alcohólica en detrimento del povidona-yodo. Sin embargo, la decisión por el mejor agente antiséptico debe considerar cada caso clínico, (contra) indicaciones y situación.

Effect of incorporation of 2-tert-butylaminoethyl methacrylate on flexural strength of a denture base acrylic resin

Polymethyl methacrylate (PMMA) resins have commonly been used as a denture base material. However, denture bases may act as a reservoir for microorganisms and contribute to oral diseases in denture wearers. It is hypothesized that the 2-tert-butylaminoethyl methacrylate (TBAEMA) incorporated to acrylic resins should have antimicrobial activity related to the presence of amino groups on acrylic resin surface. OBJECTIVES: The objectives of this study were to evaluate the presence of amino groups on acrylic resin surface and the influence on flexural strength after incorporation of TBAEMA. MATERIAL AND METHODS: Six groups were divided according to the concentration of TBAEMA incorporated to acrylic resin (Lucitone 550): 0, 0.5, 1.0, 1.5, 1.75 and 2 percent. Specimens surface were evaluated by Electron Spectroscopy for Chemical Analysis (ESCA) to detect the presence of amino groups, represented by nitrogen ratios. Flexural strength of the specimens was tested and results were analyzed by ANOVA and Tukey's test (α=0.05). RESULTS: Different nitrogen ratios were observed on specimen surfaces: 0, 0.13, 0.74, 0.66, 0.92 and 0.33 percent for groups 0, 0.5, 1.0, 1.5, 1.75, and 2 percent, respectively. Significant differences were found for flexural strength (p<0.001). The mean flexural strength values were 98.3±3.9, 93.3±3.2, 83.9±2.1, 82.8±5.2, 71.2±5.1 and 17.3±3.2 MPa for groups 0, 0.5, 1.0, 1.5, 1.75, and 2 percent, respectively. CONCLUSION: Within the limitations of this study, the incorporation of TBAEMA results in the presence of the potentially antimicrobial amino groups on specimen surfaces, but affect the flexural strength, depending on the concentration of TBAEMA.