Preoperative antiseptics in clean/contaminated maxillofacial and oral surgery: prospective randomized study.
In order to show the effectiveness of preoperative antiseptic mouthwash the authors undertook a prospective study in 120 patients who underwent elective surgery under general or local anesthesia. Patients were allocated toone of 4 groups, depending on whether the oral cavity was washed preoperatively with 1% cetrimide, chlorhexidine, povidon-iodine or sterilized normal saline solution (control group). Aerobic and anaerobic bacterial samples were taken from the inferior vestibulum mucosa before surgery, 5 min after the start of the operation and at the end of the procedure. The results show a statistically significant reduction in bacterial counts during procedures in which antiseptics are used to wash the oral cavity preoperatively. 1% cetrimide solution was the most successful in reducing intra-oral bacterial counts and produced the longest lasting antiseptic effect. Chlorhexidine is a good option for procedures longer than 1 hour, while povidon-iodine is recommended for procedures lasting up to 1 hour. Normal saline reduced bacterial counts in the specimen taken 5 min after washing but this short-lasting effect is due to mechanical cleansing rather than the antiseptic effect.
Kosutic
D
D
Department of Plastic and Reconstructive Surgery, University of Maribor General Hospital, Maribor, Slovenia. dkosutic@hotmail.com
Uglesic
V
V
Perkovic
D
D
Persic
Z
Z
Solman
L
L
Lupi-Ferandin
S
S
Knezevic
P
P
Sokler
K
K
Knezevic
G
G
D000287:Administration, Topical; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D000077286:Cetrimonium; D002593:Cetrimonium Compounds / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003666:Decontamination / Q000379:methods*; D006801:Humans; D009055:Mouth / Q000382:microbiology*; D019647:Oral Surgical Procedures / Q000379:methods*; D011206:Povidone-Iodine / Q000627:therapeutic use; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D016037:Single-Blind Method; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000891:Anti-Infective Agents, Local; D002593:Cetrimonium Compounds; D011206:Povidone-Iodine; D002710:Chlorhexidine; D000077286:Cetrimonium