[Preoperative infection prophylaxis with 1% polyvidon-iodine solution based on the example of conjunctival staphylococci].
BACKGROUND
Most germs causing postoperative endophthalmitis derive from the conjunctival bacterial normal flora. Postoperative endophthalmitis is often induced by staphylococcal germs. The application of polyvidone-iodine solution to the conjunctiva is one possibility to reduce potential endophthalmitis-causing bacteria. The aim of this study was to evaluate the effectiveness of 1% polyvidone-iodine solution concerning the reduction of colonization with staphylococci in the course of intraocular surgery. This is to evaluate the effectiveness of 1% polyvidone-iodine solution concerning coagulase-negative and positive staphylococci.


METHODS
Patients with intrabulbar surgery (300) had three conjunctival swabs taken: the first immediately prior to preoperative preparation in the operating theatre, following in-patient application of antibiotic eye drops (Polymyxin-B-sulfat, Neomycinsulfat and Gramicidin in combination); the second swab was taken after antisepsis with polyvidone-iodine before opening the conjunctiva. At the end of surgery the third smear was taken.


RESULTS
In 30.3% staphylococci were isolated from eyes before disinfection. Some patients (7.7%) were staphylococci-positive after disinfection; 5.3% of the patients showed staphylococcal growth at the end of surgery. To evaluate the effectiveness of polyvidone-iodine 1% solution we compared the first and the second smear (Mc Nemar). We found a statistically significant reduction (P < 0.001). At the end of surgery the conjunctival colonization with staphylococcal germs remained statistically significant reduced (P < 0.001). The mean operation time was 37 +/- 24 min.


CONCLUSIONS
We concluded that a significant reduction of a staphylococcal colonization can be achieved by preoperative application of polyvidone-iodine (1%) (P < 0.001). Even at the end of surgery the effect of 1% polyvidone-iodine solution held.
Binder
C A
CA
Universitäts-Augenklinik, München.
Miño de Kaspar
H
H
Klauss
V
V
Kampik
A
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D003228:Conjunctiva / Q000382:microbiology*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000517:prevention & control*; D006096:Gramicidin / Q000627:therapeutic use; D006801:Humans; D009355:Neomycin / Q000627:therapeutic use; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures; D011112:Polymyxin B / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D011206:Povidone-Iodine / Q000494:pharmacology / Q000627:therapeutic use*; D011292:Premedication; D012189:Retrospective Studies; D012996:Solutions; D013210:Staphylococcus / Q000187:drug effects* / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D009883:Ophthalmic Solutions; D012996:Solutions; D006096:Gramicidin; D011206:Povidone-Iodine; D009355:Neomycin; D011112:Polymyxin B