Comparison of an antimicrobial adhesive drape and povidone-iodine preoperative skin preparation in dogs.

The antimicrobial efficacy of an adhesive drape applied after a 1-minute alcohol scrub was compared to a povidone-iodine (PI) skin preparation technique in dogs. Each technique was applied to both sides of 15 adult anesthetized dogs on premeasured, clipped areas of skin. Skin bacteria were quantified before, immediately after, and 1 hour after skin preparation. Predominant skin bacteria were isolated by swabbing the skin. The percentages of bacterial reduction immediately after and 1 hour after skin preparation, percentages of negative culture results, cultures with more than five colony-forming units, and the frequency of skin reactions were calculated and analyzed statistically. Drape adhesion was assessed subjectively. The percentage reduction in skin bacteria was significant for both techniques and comparable to that reported in humans. The adhesive drape was significantly less effective in both the immediate and 1-hour periods. Lift occurred in 66% of drape applications but was not associated with high bacterial counts. Acute contact dermatitis was more frequent after skin preparation with PI. There was no difference between the techniques in recovery of potential skin pathogens. The authors conclude that application of this antimicrobial adhesive drape after a 1-minute alcohol scrub is not as effective in the reduction of skin bacteria in dogs as is PI preparation of the skin.

Comparison of three skin preparation techniques in the dog. Part 1: Experimental trial.

Premeasured, clipped areas of skin on both sides of 30 adult dogs were prepared with povidone-iodine (PI), chlorhexidine gluconate (CG) with a saline rinse, or 4% CG with a 70% isopropyl alcohol rinse. Skin bacteria were quantified with Replicating Organism Detection and Counting (RODAC) plates and cultured for identification before, immediately after, and 1 hour after skin preparation. The percentages of bacterial reduction immediately and at hour 1 and the percentages of negative cultures, cultures with more than five colony-forming units (CFUs), and skin reactions were analyzed by analysis of variance and chi-square. The percentage of reduction in skin bacteria for all techniques was significant and comparable with that reported in humans. There were no significant differences between PI and CG results except that acute contact dermatitis was observed more frequently after skin preparation with PI. The authors conclude that for similar application times, PI and 4% CG rinsed with saline or 70% isopropyl alcohol are equally effective for up to 1 hour in the preoperative skin preparation of dogs.

Comparison of three skin preparation techniques. Part 2: Clinical trial in 100 dogs.

The skin of 100 dogs undergoing clean or clean-contaminated surgical procedures was prepared with povidone-iodine (PI) or 4% chlorhexidine gluconate (CG) with saline or 70% isopropyl alcohol rinse. Skin bacteria at the incision site were quantified with Replication Organism Detection and Counting (RODAC) plates immediately before and after skin preparation in the preparation room, in the operating room, and postoperatively. The percentage of bacterial reduction, negative cultures, cultures with more than five colony-forming units, and skin reactions for each technique were calculated for each sample period and analyzed with the analysis of variance and Fischer tests. The percentage of bacterial reduction for all techniques was significant and comparable with results of a previous experimental study. There were no significant differences in percentages of bacterial reduction between PI and the CG techniques for surgical times up to 8 hours. There were fewer negative cultures and more cultures with high bacterial counts with PI than with CG and saline after the cleansing scrub. There were fewer negative cultures after surgery with CG and alcohol than with the other two techniques. Duration of the surgical procedure did not significantly affect the culture results. Significantly more skin reactions occurred with PI. The authors conclude that PI and 4% CG with a saline rinse are equally effective in antimicrobial efficacy under clinical conditions. However, 4% CG with a 70% isopropyl alcohol rinse may be inferior in residual antimicrobial activity.