Table 3.
Results of surgical skin preparation group.
| Study | Sample size | Type of procedure | Skin preparation | Sampling method | Results reported as ‘most effective’ |
|---|---|---|---|---|---|
| Blonna et al. 35 | 40 patients (8 male/ 32 female) | Proximal humeral fracture | Single surgical skin preparation (1% iodine povidone/50% isopropyl alcohol) vs. double skin preparation (4% CHG followed by 1% iodine povidone/50% isopropyl alcohol) | Skin swabs | Single surgical skin preparation = double skin preparation PC: Single surgical skin prep = 17.5% vs. double skin prep = 17.5% (p = 1) Bacterial load: Single surgical skin prep CFU = 9.61*102 vs. double skin prep = 1.61*102 (p = 0.07) |
| Chalmers et al. 27 | 61 patients (29 male/ 32 female) | Arthroplasty | 3% H2O2 + standard surgical skin preparation vs. standard surgical skin prep (Standard surgical skin prep: 70% ethyl alcohol + 2 ChloraPrep) | Skin swabs Dermis swabs Joint swabs | 3% H2O2 + standard surgical skin prep Standard prep = 27% (25/93) vs. H2O2 = 16% (14/90) |
| Hancock et al. 38 | 22 male healthy volunteers | No procedure | 5% BPO + standard surgical skin preparation vs. standard surgical skin preparation (Standard surgical skin preparation: ChloraPrep) | Skin swabs | None 5%BPO + standard prep: n = 9 (20%) vs. standard prep: n = 6 (14%) p = 0.57 |
| Heckman et al. 39 | 12 male healthy volunteers | No procedure | 70% isopropyl alcohol vs. ChloraPrep (2% CHG and 70% isopropyl alcohol) vs. 2% CHG and 70% isopropyl alcohol with a 2 min mechanical scrub vs. 4% CHG and 70% isopropyl alcohol with a 2 min mechanical scrub | Dermal biopsies samples | None 70% isopropyl alcohol n = 7 (58%) vs. ChloraPrep n = 5 (42%) vs. 2% CHG and 70% isopropyl alcohol with a 2 min mechanical scrub n = 6 (50%) vs. 4% CHG and 70% isopropyl alcohol with a 2 min mechanical scrub n = 6 (50%) |
| Hernandez et al. 25 | N/a | N/a | 0%, 1%, 3%, 4%, 6%, 8% , 10% H2O2 in saline or water vs. 3% topical H2O2 solution | N/a | 3% H2O2 solution applied for 5 min 3% H2O2 for 5 min vs. water-only control: p < 0.0001 3% H2O2 vs. 3% H2O2 in water or saline: p < 0.0001 |
| MacLean et al. 43 | 50 patients (22 male/ 28 female) | Open shoulder surgery | 0.1% aqueous chlorhexidine | Dermal swabs | None Total PC: 38/150 (25%) Pre-prep vs. 60 min post: p = 0.043 5 min post vs. 60 min post: p = 0.123 Pre-prep vs. 5 min post: p = 0.617 |
| Phadnis et al. 44 | 50 patients (30 male/ 20 female) | Open shoulder surgery | ChloraPrep | Skin swabs Dermal swabs Dermal biopsy | None Positive samples pre-prep vs. post-prep vs. dermal swabs vs. dermal biopsy: pre-prep n = 21 (42%) vs. post-prep n = 7 (33%) vs. dermal swabs n = 26 (52%) vs. dermal biopsy n = 20 (40%) |
| Stull et al. 33 | 140 male patients | Arthroscopy | 3% H2O2 + standard surgical skin preparation vs. standard surgical skin preparation (Standard surgical skin preparation: 2% CHG + 7.5% povidone-iodine solution + 2 ChloraPrep | Punch biopsy samples | 3% H2O2 + standard surgical skin preparation H2O2 = 17.1% vs. control = 34.2% (p = 0.033) |
| Yamakado 34 | 126 patients (88 men and 38 women) | Arthroscopy | 1% CHG and 70% alcohol with drape vs. 1% CHG and 70% alcohol without drape vs. povidone iodine with drape vs. povidone iodine without drape | Skin swabs | 1% CHG and 70% alcohol with drape 1% CHG + 70% alcohol with drape n = 3/32 (9.3%) vs. 1% CHG + 70% alcohol without drape n = 10/30 (33%) vs. povidone iodine with drape n = 11/33 (33%) vs. povidone iodine without drape n = 14/31 (47%) |
BPO: benzoyl peroxide; CFU: colony forming units; ChloraPrep: 2% CHG + 70% isopropyl alcohol; CHG: Chlorhexidine gluconate; H2O2: hydrogen peroxide.