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Data published in the Journal of Bone and Joint Surgery demonstrates that use of the preoperative skin preparation ChloraPrep from CareFusion Corp. is effectiveat eliminating overall bacteria from the shoulder region. After antisepsis with ChloraPrep (2 percent chlorhexidine gluconate and 70 percent isopropyl alcohol), only 7 percent of skin cultures tested positive for bacteria compared to 31 percent (p<0.0001) for povidone-iodine.(1)
"While the presence of bacteria on the skin doesn't automatically lead to an infection, significantly reducing bacteria on a patient's skin is a key component of reducing the overall risk of infection," said Dr. Matthew D. Saltzman, principal study investigator and assistant professor at Northwestern University. "In terms of bacterial reduction, these study results suggest that ChloraPrep may better protect patients."
Bacteria on the skin is the No. 1 cause of surgical site infections, which affect approximately 300,000 to 500,000 Americans each year.(2,3) These infections occur when bacteria and other microorganisms, naturally found on the patient's skin or on the hands of a health care worker, enter the body through an incision site. Infection following surgery can be a devastating problem, leading to re-hospitalization or need for additional surgery or treatment. It is estimated that surgical site infections result in annual cost to hospitals of approximately $7.4 billion.(3)
"Surgical site infections pose a major health threat to patients, and are costly for the healthcare system," said Cindi Crosby, vice president of global medical affairs, infection prevention, with CareFusion. "This study adds to the growing clinical body of evidence that supports use of ChloraPrep for skin prepping prior to surgery."
This randomized, prospective study evaluated 150 patients undergoing shoulder surgery after being prepared with ChloraPrep, iodine or another prep solution. The goal of the study was to examine the native bacteria presence around the shoulder and determine the efficacy of three different surgical skin preparation products on the eradication of bacteria from the shoulder. Funding of this study was provided as an unrestricted educational grant by CareFusion, manufacturer of ChloraPrep. This funding was used exclusively for microbiology expenses, and the company was not involved with the organization or analysis of the data.
ChloraPrep is a patient preoperative skin preparation that is designed to reduce microorganisms on patients' skin prior to medical and surgical procedures. It provides rapid action against a broad range of microorganisms, including MRSA, and keeps fighting bacterial growth for at least 48 hours after application.(4,5) The ChloraPrep applicator was designed to minimize direct hand-to-patient contact, helping reduce the risk of cross-contamination of microorganisms. This is important because the transmission of some bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), happens almost exclusively via the hands, especially the hands of health care workers.(6) The efficacy and safety of ChloraPrep are supported by more than 35 clinical studies and recommendations by 17 internationally recognized organizations or guidelines, including 10 that specifically recommend 2 percent chlorhexidine gluconate, a key ingredient in ChloraPrep.
(1) Saltzman MD, Nuber GW, Gryzlo SM, Mareced GS, Koh JL. Efficacy of Surgical Preparation Solutions in Shoulder Surgery. J Bone Joint Surg Am. 2009; 91:1949-53.
(2) Martone WJ, Nichols RL. Recognition, prevention, surveillance, and management of surgical site infections: introduction to the problem and symposium overview. Clin Infect Dis.2001;33 Suppl 2:S67-S68.
(3) Centers for Disease Control and Prevention (CDC). Healthcare Infection Control Practices Advisory Committee (HICPAC): HHS Efforts to Reduce Healthcare-associated Infections. November 13, 2008. Available at: http://www.cdc.gov/ncidod/dhqp/hicpac_HHS_EffortsReduceHAI_textonly.html. Accessed on August 10, 2009.
(4) Garcia R, Mulberry G, Brady A, Hibbard JS. Comparison of ChloraPrep and Betadine as preoperative skin preparation antiseptics. Poster presented at: 40th Annual Meeting of the Infectious Disease Society of America; October 25, 2002.
(5) Data on file. CareFusion.
(6) Centers of Disease Control and Prevention. MRSA in Healthcare Settings. Available at: http://www.cdc.gov/ncidod/dhqp/ar_MRSA_spotlight_2006.html. Accessed August 10, 2009.