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(3) Intraoperative Skin Prep: Is There A Difference? A Retrospective Review

Jennifer L. Zinn, MSN, RN, CNS-BC, CNOR
Clinical Nurse Specialist, Operative Services, Cone Health

Abstract:

Surgical Site Infection (SSI) is the most common type hospital-acquired infection in the surgical population with nearly 750,000 occurring annually. An individualís risk for dying is 11 times greater with the occurrence of an SSI. Additionally, SSIs increase length of stay by seven to 31 days per event resulting in $1.6 billion in cost for treatment. Hospitals are challenged to evaluate current practices to decreases SSI. The purpose of this project was to identify which intraoperative prepping solution utilized in our health network for adult open abdominal surgical procedures had the lowest incidence of SSI 30-days postoperatively. A retrospective medical record review was conducted of consecutive patients age 18 years and older undergoing elective open abdominal procedures at four acute care, community hospitals within an integrated tertiary health network in the Southeastern US from December 2008 to December 2010. Results: The sample (N=162) was predominately white (67%) female (67%) with a wound class 2 (58%) and a mean age of 49 (± 13.26) years. Procedures using PCMX intraoperative solution (n = 71) resulted in no SSI, while procedures that used other prepping solutions (CHG, povidone-iodine, and iodine-base with alcohol) (n=91) resulted in five SSIs. Chi-square test indicated a significant difference in the incidence of SSI among PCMX intraoperative prep solution when compared to the other solutions in open abdominal surgical procedures (2 = 4.025 (1, 162), p = 0.045). Research on this subject acknowledges an appropriate and effective surgical skin antiseptic plays a vital role in the prevention of devastating postoperative infections. By staying abreast of research and understanding the advantages and disadvantages of available surgical skin antiseptics, perioperative registered nurses are able to make informed recommendations.

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