title: Bacterial recolonization during foot surgery: a prospective randomized study of toe preparation techniques.
abstract: Fifty patients undergoing foot or ankle surgery were randomized into two groups for the purposes of toe preparation. Twenty-four patients underwent a standard preparation which included placing antiseptic between the toes while 26 were additionally cleaned by sliding a gauze swab soaked in topical antiseptic back and forth several times. Povidone iodine followed by chlorhexidine in alcohol was used in both groups. All toes were covered by a sterile glove during surgery unless the toes themselves were to be operated upon. Bacteria were cultured from the toe clefts in 4% of all patients immediately following preoperative disinfection. Significantly fewer patients whose toes had been additionally scrubbed (group 1) showed bacterial recolonization at the end of surgery compared with those undergoing a standard prep (group 2) (7.7% vs 20.8%). We conclude that additional scrubbing of toe clefts prior to surgery reduces the incidence of recolonization of bacteria during the surgical procedure.
authors.affiliation: adam.brooks@btinternet.com
authors.forename: R A
authors.initials: RA
authors.lastname: Brooks
authors.forename: D
authors.initials: D
authors.lastname: Hollinghurst
authors.forename: W J
authors.initials: WJ
authors.lastname: Ribbans
authors.forename: M
authors.initials: M
authors.lastname: Severn
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000985:Antisepsis / Q000379:methods*; D001419:Bacteria / Q000302:isolation & purification*; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015169:Colony Count, Microbial; D005260:Female; D005528:Foot / Q000601:surgery*; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000627:therapeutic use; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D011481:Protective Clothing; D012867:Skin / Q000382:microbiology*; D013210:Staphylococcus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D014034:Toes / Q000382:microbiology*
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine