Wound healing under the effect of iodine cadexomer in rats / Cicatrização de feridas sob efeito do cadexômero iodo em ratos

PURPOSE: To assess vthe action of iodine cadexomer in the healing process of surgical wounds in rats and if cytotoxicity occurs with the systemic absorption of iodine. METHODS: Thirty six Wistar rats were used and performed 53 wounds with surgical punch of 6 mm diameter on them. Two lesions were made diametrically opposed on groups with distilled water (GAD) and sodium chloride (GCS); on the right lesions were used bandage with distilled water and on the left ones dressing with sodium chloride. In cadexomer iodine (GCI) group, a punch injury was made only on the left side and the dressing was carried out with cadexomer iodine. The groups were divided in two sub-groups according to the day of death (7 and 14). Microscopically was used H&E staining, through which the inflammation could be observed and also the neovascularization. Staining with Masson trichrome studied fibrosis. TSH and free T4 were used for absorption recognition of iodine, and its toxic potential was performed before death with the animal anesthetized. RESULTS: Microscopic analysis showed more marked intensity of inflammation in group GAD, subgroup 14 days. Neovascularization showed be discrete in GCS sub-group 14 days. Fibrosis was more pronounced in the group GCI. Comparing the types of treatment, there was statistical significance between groups GCI and GCS (p<0.013). The TSH and T4, showed no difference between the control group and GCI in relation to the absorption of iodine. In evaluating the GCI and control groups, within each treatment, statistical significance was found between them (p<0.001) when compared the days of observation. CONCLUSION: Cadexomer iodine had beneficial effects in all phases of the healing process without cytotoxicity due iodine absorption.

OBJETIVO: Avaliar a ação do cadexômero iodo na cicatrização de feridas cirúrgicas em ratos e se ocorre citotoxicidade com a absorção sistêmica do iodo. MÉTODOS: Utilizou-se 36 ratos Wistar nos quais realizaram-se 53 feridas cirúrgicas com punch de 6 mm de diâmetro. Foram confeccionados duas lesões diametralmente opostas nos animais dos grupos água destilada (GAD) e cloreto de sódio (GCS). Na lesão do lado direito foi utilizado curativo com água destilada e, na do esquerdo, curativo com cloreto de sódio. No grupo cadexômero iodo (GCI), foi feita apenas uma lesão com o punch no lado esquerdo e o curativo foi realizado com cadexômero iodo. Os grupos foram divididos em dois subgrupos conforme o dia da morte (7 e 14). Microscopicamente foi utilizada a coloração H&E, através da qual foi observado o processo inflamatório e a neovascularização. Com a coloração tricômio de Masson foi estudada a fibrose. Para o reconhecimento da absorção do iodo e o seu potencial tóxico foi realizado, antes da morte com o animal anestesiado, dosagem do TSH e do T4 livre. RESULTADOS: Na análise microscópica a intensidade da inflamação apresentou-se mais acentuada no grupo GAD, subgrupo 14 dias. Na análise da neovascularização ela apresentou-se discreta no GCS subgrupo 14 dias. Na avaliação da fibrose foi mais acentuada no grupo GCI. Na comparação nos tipos de tratamento houve significância estatística entre os grupos GCI e GCS (p<0,013). A dosagem do TSH e T4, não apresentou diferença entre o grupo controle e GCI em relação à absorção do iodo. Na avaliação dos grupos GCI e controle, dentro de cada tratamento, houve significância estatística entre eles (p<0,001), quando comparados os dias. CONCLUSÃO: O cadexômero iodo apresentou efeito benéfico em todas as fases do processo cicatricial sem citotoxicidade pela absorção do iodo.

[Effects of post-milking teat dipping changing on bulk tank milk bacterial status]

Contagious and environmental bacteria are current causes of mastitis and Bulk Tank Bacteria Count [BTBC]. Beside other hygienic procedures related to controlling mastitis, Post-Milking Teat Dipping [PMTD] with a suitable teat antisepsis has a special place and can play an important role in the kind of herd mastitis and decreasing the Total Bacteria Count [TBC]. This study was performed to evaluate the efficiency of short-time changing of PMTD solution on count and kind of milk tank bacteria. This study was conducted in 2 large dairy farms that their current antisepsis was iodophor components in 4 periods around Tehran during March to August 2010. In each 4 periods after the last time that iodophor was used, milk transfer tank sample was collected and 3 tests include Bulk Tank Somatic Cell Count [BTSCC], milk quality tests and bacterial isolation were performed. Then, antisepsis was replaced with chlore components for at least 2 weeks. At the end, another milk tank sample was obtained and tests were done again. Sectional changing of iodophor with chlore components in all 4 periods, according to decreasing in TBC, Coliform count, preliminary incubation count, laboratory pasteurized count, Staphylococcus count and Streptococcus count caused increasing the quality of milk and decreasing the mastitis. Changing in post-milking teat dipping has positive effect on quality of raw milk

B-ultrasound guided aspiration and sclerotherapy with 2% iodophor for renal cysts / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of B-ultrasound-guided aspiration and sclerotherapy with 2% iodophor for treatment of renal cysts.</p><p><b>METHODS</b>Twenty-eight cases of sympotomatic renal cysts were treated with B-ultrasound-guided aspiration followed by sclerotherapy with 2% iodopher, which was maintained for 20 min. After extraction of iodopher, another injection of 2% iodopher (5-10 ml) into the cysts was given. The patients were followed up for 6 months to 18 months.</p><p><b>RESULTS</b>Full recovery was achieved in 25 cases and improvement in 2 cases. Recurrence was found in 1 case after the treatment.</p><p><b>CONCLUSIONS</b>B-ultrasound-guided aspiration and sclerotherapy with 2% iodophor is safe, minimally invasive, and highly effective for treatment of symptomatic renal cysts.</p>

Comparative Efficacy for Dressing Methods of Iodine on Infected Full Thickness Skin Wound in the Mouse

PURPOSE: Iodine has been used for the prevention or management of wound infection as a topical agent. Although iodine was widely used mainly by Betadine(R) and cadexomer iodine, there was no comparative study on the efficacies of dressing methods of iodine. And also it's wound healing effect was not yet clear. The purpose of this study is to compare antibacterial effects and wound healing effects associated with various dressing methods of iodine on infected full thickness skin defect in the mouse. METHODS: One full thickness skin defects in the mice (n=60) were developed on the back and left open for twenty-four hours. Sixty mice were divided into four groups : group S(dressing with Betadine(R) soaking, n=15), group T (dressing with Betadine(R) topping, n=15), group I(dressing with Iodosorb(R), n=15), group G(control group, dressing with dry gauze, n=15). The size of the wound defects and the grades of wound healing were evaluated in 4, 7, 10 days, and antibacterial effect was evaluated with restricted zone in Mueller Hinton agar by disk diffusion method. RESULTS: After the wound was left open for twenty-four hours, many Staphylococcus aureus were cultured. The wound defect size was decreased in order of Betadine(R) soaking, Iodosorb(R), Betadine(R) topping and gauze dressing group in all days, but difference among experimental groups was not statistically significant. The grade score of wound healing was increased in order of Betadine(R) soaking, Iodosorb(R), Betadine(R) topping and gauze dressing group, and the difference was statistically significant. Antibacterial effect for S. aureus was increased in order of Iodosorb(R), Betadine(R) soaking, Betadine(R) topping and gauze dressing group, and the difference was statistically significant. CONCLUSION: Selection of the effective dressing method of iodine for infected wounds remains a controversial decision. According to this study, Iodosorb(R) may be most effective method for antibacterial effect and Betadine(R) soaking may be most effective method for infected wound healing. However, further study is necessary to evaluate the clinical efficacy of dressing methods of iodine and to search for the mechanisms that explain their effects.

Effect of disunfection of acrylic resin custom trays on adhesive property of polyvinyl siloxane impression material adhesive systems

The bond strength for elastomeric materials to prevent detachment of the impression from the custom tray is important. The effect of disinfection procedure of custom trays with freshly prepared 1:213 iodophor and 10% sodium hypochlorite disinfectants on the tensile bond strength of polyvinyl siloxane impression adhesive/ systems were evaluated. Thirty autopolymerizing resin plates were made in silicone mold. Before, the resin became rubbery, a metal nut with retentive threads was embedded so that an eye bolt could be thread into it for attachment during tensile testing. The specimens were stored in ambient air for 24 hours before testing. Ten specimens were exposed to freshly prepared 1:213 iodophor and additional 10 resin specimens were exposed to freshly made 10% sodium hypochlorite disinfectant solution. The specimens were stored in sealed plastic bags for 24 hours. The remaining 10 specimens served as control. After application of adhesive, addition reaction silicone impression material was injected over the tray specimens. The force necessary to separate the impression from the tray material was recorded using Instron Universal Load Testing Machine. The results indicated that the use of iodophor and sodium hypochlorite disinfectant solutions reduced the bond strength of impression adhesive system to autopolymerizing resin tray compared to control [iodophor = .38 MPa, sodium hypochlorite= .49 MPa, control .52MPa]. It is therefore suggested to perforate the tray at the construction stage and disinfected in the laboratory to overcome the reduced bond strength of polyvinyl adhesive / system to tray material

Topical iodophor use in chronic wounds: a literature review

This study aimed to do a review of the literature regarding the use of topic iodine and/or compounds in the treatment of chronic wounds. The clinical trials were searched in the Cochrane database. Fourteen (58.3 percent) among 24 studies fulfilled the inclusion criteria. The articles were analyzed regarding journal and study characteristics and classified into three groups: Iodine versus other topic agents (7/ 50 percent); Iodine versus different dressings (6/ 42.9 percent); Iodine versus without Iodine (1/ 7.1 percent). Favorable results for the use of Iodine or similar product occurred in 50 percent of the analyzed studies. Six out of 8 trials showed favorable results for healing and infection prevention/ treatment; 4 out of 5 were not favorable when the healing objective was investigated and 1 study for infection treatment showed no favorable result.

La investigación trata de una revisión de la literatura a cerca de la utilización del yodo tópico y/o compuestos en el tratamiento de las heridas crónicas. Se buscaran los ensayos clínicos en el Cochrane. Catorce (n=24) publicaciones estaban de acuerdo con los criterios de inclusión, y fueran analizadas según las características de las revistas y ensayos y clasificadas como: yodo versus otros agentes tópicos (7/ 50 por ciento); yodo versus curativos (6/ 42,9 por ciento) y yodo versus sin yodo (1/ 7,1 por ciento). Fueran obtenidos resultados favorables a la utilización del yodo y/o compuestos en 50 por ciento de los artículos analizados. Cuanto a las tendencias de los resultados, 6 de 8 publicaciones, a cerca de la de cicatrización de las heridas y prevención de infección, fueran favorables; 4 de 5 fueran no favorables solamente para la cicatrización, y el resultado del único trabajo con indicación del uso para tratamiento de infección de herida fue no favorable.

Trata-se de revisão de literatura relacionada ao uso de iodóforos tópicos no tratamento de feridas crônicas. Os ensaios clínicos foram localizados por meio da Base de Dados Cochrane de Revisões Sistemáticas e Registro Cochrane Central de Ensayos Controlados. Quatorze (58,3 por cento), dentre 24 artigos, atenderam os critérios de inclusão, analisados quanto às características dos periódicos e dos estudos e classificados em três grupos: iodóforo versus outros agentes tópicos (7 ou 50 por cento); iodóforo versus coberturas (6 ou 42,9 por cento) e iodóforo versus sem iodóforo (1 ou 7,1 por cento). Resultados favoráveis à utilização dos iodóforos ocorreram em 50 por cento dos artigos analisados. Quanto às tendências dos resultados, seis, dentre oito artigos, que tratavam de cicatrização de feridas e prevenção de infecção, foram favoráveis; quatro, dentre cinco, foram desfavoráveis somente para a cicatrização e no único ensaio em que houve indicação do seu uso para tratamento de infecção de ferida o resultado foi desfavorável.

Comparative study on the resistance of Bacteriophage phi chi 174D, T4 and f2 to an iodophor in laboratory / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To screen for the most resistant bacteriophage as indicator in disinfection tests, the resistance of bacteriophage phi chi 174D, T4 and f2 to iodophor were observed in laboratory.</p><p><b>METHODS</b>The virucidal activity of iodophor against bacteriophage phi chi 174D, T4, and f2 were assessed by suspension test. The neutralizer is selected and appraised by testing with neutralizer. Bacteriophage phi chi 174D, T4, and f2 were detected and enumerated by the double-agar-layer plaque technique.</p><p><b>RESULTS</b>(1) With 500 mg/L of available iodine of iodophor solution, within a contact time of 40 min, or 750 mg/L, 10 min, or 1000 mg/L, 5 min, the reduction of bacteriophage phi chi 174D could achieve the "disinfection" level [log10 inactivation value (LIV) or log10 reduction value (LRV) of bacteriophage phi chi 174D (log10 No-log10 Nt) was > or = 4.00 log10]. (2) With 600 mg/L of available iodine of iodophor solution, within a contact time of 40 min, or 700 mg/L, 5 min, the reductions of bacteriophage T4 could achieve the "disinfection" level. (3) With 50 mg/L of available iodine of iodophor solution, within a contact time of 10 min, or 75 mg/L, 10 min, the reductions of bacteriophage f2 could achieve the "disinfection" level.</p><p><b>CONCLUSION</b>The order of resistance of the above three bacteriophages to iodophor from greatest to smallest is as follows: bacteriophage phi chi 174D greater than bacteriophage T4 > bacteriophage f2.</p>

Anti-sépticos e técnicas de anti-sepsia: atualização / Antiseptics and antisepsis techniques: update

A importância da lavagem das mãos e do uso de técnicas anti-sépticas em ambiente hospitalar para se prevenir infecções é conhecida há décadas. A flora microbiana da pele sadia tem uma população residente e uma transitória. A diminuição da microbiota da pele, através dos anti-sépticos e da lavagem/escovação das mãos, reduz o risco de infecção. Os anti-sépticos compostos de iodo, iodóforos e clorexidina têm eficácia semelhante. A correta execução das técnicas de anti-sepsia e o uso individualizado dos atuais anti-sépticos, com base no custo e ação, devem ser adaptados a cada setor de atendimento à saúde.

Comparison of susceptibilities of M. tuberculosis H37Ra and M. chelonei subsp. abscessus to disinfectants / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the susceptibilities of M. tuberculosis H37Ra and M. chelonei subsp. absecessus to several frequently-used disinfectants and to evaluate the practicability of surrogating M. tuberculosis by the latter.</p><p><b>METHODS</b>A suspension quantitative bactericidal test was set up in accordance with Chinese Technique Standard for Disinfection to evaluate the susceptibility of each mycobacteria strain to each selected disinfectant. Killing log value was used as criterion in comparing the susceptibility to disinfectants between the two strains.</p><p><b>RESULTS</b>M. chelonei subsp. abscessus was more resistant to chlorine disinfectant than M. tuberculosis while the two strains were similarly resistant to iodophor disinfectant, peracetic acid, alcohol and glutaraldehyde disinfectant.</p><p><b>CONCLUSION</b>M. chelonei subsp. abscessus has the potential to surrogate M. tuberculosis in evaluating mycobactericidal efficacies of disinfectants.</p>

hygienic effect of iodophor on air and water qualities with their reflection on broiler performance

Four hundred apparently healthy white [Arbor Acres] one-day-old chicks were housed under appropriate hygienic conditions on deep litter system. At the one week age, the birds were divided into 4 groups [control, [G-A], [G-B], [G-C]] each of 100 birds. Starting from this age [one week old] until the age of [42 days], group [A] received drinking water containing 25-ppm active iodine, group [B] received the same sanitizing drinking water [25-ppm active iodine] beside: aerosolized 10-ppm active iodine [50 ml. of 10-ppm iodine / 10 m 2 space area] and this aerosolization of iodine was done twice/week. Group [C] was only aerosolized -with 10-ppm active iodine with the same previous amount. The control group received fresh water without additional improvement with the iodine and was away from the iodine aerosolization. After using the iodine as a saniitizer for water and air, the mean values of total bacterial and coliform counts in water and also the mean value of total bacterial count in air showed highly significant difference [P<0.001] in comparison with control group. All broilers' groups, including control one, showed good performance [over 150] according to the modified European Performance Factor "MEPF". Also, the average final body weight and the feed utilization efficiency were nearly equal in all groups. However, group-B in which both air and water were sanitized with iodine, revealed numerical superiority with respect to final body weight [20 grams more than the control group], average FUE [1.93] and the MEPF [203.6] than the other groups. It could be recommended to use iodine as an air sanitizer [at 10-ppm concentration], at the same time with its use as a water sanitizer [with 25-ppm concentration], in addition of improvement of broilers' performance

Study on the resistance of methicillin-resistant staphylococcus aureus to iodophor and chlorhexidine / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the resistance of methicillin-resistant staphylococcus aureus (MRSA), an indicator used in hospitals.</p><p><b>METHODS</b>We used minimal inhibitory concentrations (MIC) of iodoph and chlorhexidine to MRSA, methicillin-sensitive staphylococcus aureus (MSSA) and staphylococcus aureus ATCC6538.</p><p><b>RESULTS</b>Obvious difference between MRSA and MSSA the MIC of Iodophor was noticed. Among MICs, 5.3% MRSA strains were 2-folds and 28.9% MRSA strains were 1.5 fold more than staph. aureus ATCC6538, while the MIC of 11.1% MSSA strains raised 1.5 fold than ATCC6538. The MIC of 83.3% MSSA strains were the same to staph. aureus ATCC6538. The MIC of chlorhexidine to MRSA, MSSA and staphylococcus aureus ATTC6538 were similar to each other.</p><p><b>CONCLUSION</b>Results showed that some MRSA were more resistant to Iodophor than staph. aureus ATCC6538, but remained the same resistance to Chlorhexidine. Thus the concentration of Iodophor should be raised when the resistant strains were isolated.</p>

Avaliação do efeito imediato e residual do sabão anti-séptico, do PVP-I degermante, do PVP-I tópico e da clorexidina na degermação das mãos / Evaluation of immediate and residual effect of liquid soap, degerming povidine-iodine, topic povodine-iodine and chlorhexidine on handwashing

O objetivo deste trabalho foi avaliar o efeito imediato e residual da água e do sabão bactericida, do PVP-I degermante, do PVP-I tópico e da clorexidina na degermação das mãos de graduandos da Faesa-Vitória, em procedimentos críticos. A coleta microbiológica foi realizada antes da degermação, após a degermação e uma hora após o uso de luvas. Foi possível concluir que: houve diferença significante entre o grupo água e sabão e os demais; a lavagem das mãos com água e sabão não inibiu o crescimento de Staphylococcus sp imediatamente; o PVP-I degermante e o PVP-I tópico e a clorexidina impediram o crescimento de qualquer micro-organismo no ato de seu uso e 1 hora depois

Anti-sepsia mecânica e química das mãos e antebraços da equipe cirúrgica / Mechanical and chemical anti-sepsis of hands and forearms of the surgical team

Os autores apresentam estudo sobre técnicas de anti-sepsia das mãos e antebraços no preparo pré-operatório da equipe cirúrgica. O objetivo do estudo foi o de verificar qual a importância da escovação (anti-sepsia mecânica) neste preparo. Para tal, estruturaram duas técnicas: anti-sepsia mecânica e química (técnica A), onde foi realizado escovação das mãos e antebraços com sabão comum a aplicação de solução anti-séptica, e somente anti-sepsia química (técnica B). Os resultados foram expressos na forma de contagem de colônias bacterianas provenientes das impressões digitais das mãos dos voluntários do estudo em placas de cultura. A solução anti-séptica utilizada foi iodo orgânico (Povidine). Os resultados mostraram não haver diferença estatisticamente significante entre as duas técnicas quanto a sua eficácia na redução da contagem de colônias bacterianas e permitem concluir que a aplicação isolada de solução anti-séptica de iodo orgânico é tão eficaz quando em associação com escovação prévia (anti-sepsia mecânica)

Estudo da estabilidade à temperatura ambiente de soluçöes de PVP-I tópica e degermante ( / Study of topic and soap PVP-I solutions at room temperature

A polivinilpirrolidona-iodo, também conhecida como PVP-I, é um dos anti-sépticos mais utilizados pelos profissionais da área da saúde, por possuir as mesmas propriedades germicidasdo iodo sem as desvantagens deste, ou seja, causar irritaçäo à pele e às mucosas, ser tóxico, apresentar baixa solubilidade em água. Esse produto é comercializado sob diversas formas farmacêuticas, sendo as mais conhecidas as soluçöes para uso tópico, degermante e tintura. Säo escassas as refências sobre a estabilidade dessas formas farmacêuticas. Neste trabalho, soluçöes de PVP-I aqüosas e degermante (existentes no mercado e por nós desenvolvidas), foram mantidas em prateleira à temperatura ambientepor um ano, analizando-se o teor de iodo e medindo-se o pH a cada 30 dias.

Avaliaçäo e controle da qualidade microbiológica de mäos de manipuladores de alimentos / Microbial evaluations and control workers' hands

Foi conduzido monitoramento microbiológico das mäos de manipuladores de alimentos como parte de um estudo para implantaçäo do Sistema de Análise de Perigos e Pontos Críticos de Controle em um restaurante institucional, através da contagem padräo de aeróbios mesófilos e anaeróbios facultativos, S. aureus, C. perfringens e presença de Salmonella spp. Foram observadas contagens de microrganismos aeróbios mesófilos e anaeróbios facultativos em níveis de até 10 7 UFC/mäo, contaminaçöes por S. aureus e C. perfringens e oportunidades de contaminaçäo cruzada por essas mäos principalmente no fatiamento da carne assada. Salmonella spp. näo foram isoladas. Foram adotadas medidas corretivas para este ponto crítico de controle, constatando de lavagem das mäos dos manipuladores com água corrente e sabonete líquido neutro seguida de antissepsia com iodóforo. Foram observadas reduçöes da contagem de aeróbios mesófilos em até 2,6 ciclos log e, apesar desta reduçäo näo ser a ideal, ela demonstra a contribuiçäo que esta prática pode trazer aos serviços de alimentaçäo, além do que näo foram mais detectados microrganismos patogênicos como S. aureus e C. perfringens

Efectividad del lavado quirurgico de manos en salas de cirugia del Hospital San Ignacio / Effectiveness of the surgical handwash in the operating room from Hospital San Ignacio

Estudio descriptivo evaluativo de corte transversal para medir la efectividad del lavado quirurgico de manos realizado por el personal de los quirofanos. Inicialmente, se observo la tecnica usada por 20 cirujanos, 10 instrumentadoras y 5 estudiantes de enfermeria sin informar al sujeto de estudio; los datos se registraron en una guia previamente elaborada, puesto que no se contaba con un protocolo. Posteriormente, se hicieron cultivos de la palma y las unas de las manos antes del lavado, inmediatamente despues y al finalizar la operacion, encontrandose que el 68.57 por ciento de las personas tenian algun tipo de microorganismos en las palmas antes del lavado y de estos el 37.5 por ciento eran patogenos. En el 88.57 por ciento se encontraron germenes en las unas, de los cuales el 32.26 por ciento fueron patogenos despues del lavado de manos. El 50 por ciento utilizo isodine y el otro 50 por ciento clorhexidina como jabon quirurgico. La tecnica de lavado de manos fue eficaz, para las palmas en el 79.16 por ciento , mientras que en quienes usaban unas largas no fue util el lavado de manos porque el 84.6 por ciento continuaba con microorganismos en contraste con quienes usaban unas cortas, en quienes solo se encontro flora en 31.8 por ciento . De las que entraron a cirugia con las manos libres de microorganismos, 86.66 por ciento despues de cirugia continuaron con cultivos negativos aun despues de 210 mia de cirugia sin que hubiese relacion con el tipo de herida quirurgica, aun cuando si la hubo con el tipo de personal. Se propone establecer un protocolo que incluya las tecnicas, los antisepticos empleados por las personas que presentaron cultivos negativos..

Comparison of effects of alcohol, chlorhexidine cream, and iodophore cream on venous catheter-associated infections.

The effects of alcohol, chlorhexidine cream and iodophor cream on the infectious complications associated with intravenous catheters were studied. One hundred and fifty patients were randomly allocated into each antiseptic group. Daily cleansing and disinfecting the cut down wounds were done with the above antiseptics. Minor surgical wound infections were found in one patient in the alcohol and iodophor group compared to five in the chlorhexidine group. Phlebitis complicated four patients, two in the iodophor group and one in each of the remaining groups. Only one patient in the chlorhexidine group had septicaemia due to A. antitratus. Thirty-four catheter tips (22.7%) yielded bacteria on culture. Incidence of positive tip cultures was significantly higher in the chlorhexidine group than in the other two. The rates of positive tip cultures correlated with duration of catheterization. It is concluded that alcohol is the antiseptic of choice for cut down wounds. Application of antiseptic cream to the wounds was less effective than alcohol and this practice should be discouraged.