title: Influence of preoperative skin sealing with cyanoacrylate on microbial contamination of surgical wounds following trauma surgery: a prospective, blinded, controlled observational study.
abstract: OBJECTIVE
  Intraoperative bacterial contamination is a risk factor for surgical site infections (SSIs). This prospective, randomized, blinded, controlled trial (Reg. No. BB08/12) investigated the effect of a cyanoacrylate-based skin sealant (InteguSeal) on intraoperative wound contamination during trauma surgery.
  
  
  METHODS
  A total of 128 patients undergoing trauma surgery were assigned randomly to an intervention (n=62) or a control group (n=66). Surgical sites were investigated at three locations: maximum incision depth (base), wound margin prior to wound closure (margin), and the surgical sutures (suture). Colony-forming units (CFU) were counted after 48h of incubation.
  
  
  RESULTS
  Overall, significantly lower CFU counts were obtained for samples from the intervention group at all three sample sites compared to the control group. The difference, however, was only significant for the suture site (p=0.040).
  
  
  CONCLUSIONS
  Preoperative sealing reduced microbial contamination on sutures during surgery, while the overall wound contamination remained unchanged. Hence, prevention of the clinically more relevant deep SSIs may not be expected. However, this study was not designed to detect differences in the rate of SSI. The role of the reduction in suture contamination with regard to the prevention of SSI remains to be evaluated.
authors.affiliation: Department of Dermatology, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Daeschlein
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Clinic of Surgery, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Napp
authors.affiliation: Department for Hospital Hygiene and Infection Control, Medical University of Vienna, Austria. Electronic address: ojan.assadian@meduniwien.ac.at.
authors.forename: Ojan
authors.initials: O
authors.lastname: Assadian
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Bluhm
authors.affiliation: Department for General, Visceral and Vascular Surgery, Vivantes Humboldt-Klinikum, Berlin, Germany.
authors.forename: Colin
authors.initials: C
authors.lastname: Krueger
authors.affiliation: Department of Dermatology, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: von Podewils
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Clinic of Surgery, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Denis
authors.initials: D
authors.lastname: Gümbel
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Clinic of Surgery, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hinz
authors.affiliation: Department of Dermatology, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Haase
authors.affiliation: Heart Centre Leipzig GmbH, University Clinic Leipzig, Leipzig, Germany.
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Dohmen
authors.affiliation: Hygiene Nord GmbH, Greifswald, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Koburger
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Clinic of Surgery, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Ekkernkamp
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine, Ernst-Moritz-Arndt University Greifswald, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification; D003487:Cyanoacrylates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011897:Random Allocation; D012867:Skin; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000382:microbiology* / Q000601:surgery; D055815:Young Adult
chemical_list: D003487:Cyanoacrylates
keywords: Cyanoacrylate; InteguSeal; Microbial sealant; Prevention; SSI; Wound