title: Efficiency of Local Antiseptic Alkosol (Ethanol, Isopropanol-30g and Ortophenilphenol) and Povidone Iodide on the Incidence Of Surgical Site Infection After Inguinal Hernioplasty.
abstract: BACKGROUND
  The risk of wound infection after elective inguinal hernia repair depends on several factors. One of the most important factors is the preoperative skin preparation. The use of antisepsis is performed to reduce the risk of surgical site infections (SSIs) and to remove causing organisms. This work compares two different agent forms for preoperative skin preparation to prevent SSIs.
  
  
  OBJECTIVE
  The objective of the study is comparing the effects of two different agents used for preoperative skin preparation and prevention of SSIs.
  
  
  METHODS
  100 adult patients were divided and randomized into two groups, each containing 50 patients. Both groups included patients that are scheduled for elective Lichtenstein inguinal hernia repair. The first group includes patients whose skin preparations were done with povidone iodine (PI) only. The second group included patients that are treated with two antiseptics; Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide. Alkosol is applied before the induction of anesthesia. The povidone iodide is applied after Alkosol has evaporated. The presence of bacterial growth in the wound was determined 24 and 48 hours after operation. Swabs were used to take samples, which were then cultivated to check for bacterial growth. The presence of infection was also determined by the following criteria: pain or tenderness, induration, erythema, local warmth of the wound etc.
  
  
  RESULTS
  The surgeon or clinician declared that after 24 hours the wound was infected in 20 patients in the control group and in 22 patients after 48 hours. In the Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide group infection was declared in only 3 patients after 24 hours.
  
  
  CONCLUSIONS
  Compared to the use of providone only, the use of Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide has many advantages and was associated with lower rates of SSIs following clean surgery. A larger trial is warranted in order to add definitive and more conclusive data to the current evidence base.
authors.affiliation: General Hospital "Prim. dr. Abdulah Nakaš "Sarajevo", Sarajevo, Bosnia and Herzegovina.
authors.forename: Harun
authors.initials: H
authors.lastname: Djozic
authors.affiliation: General Hospital "Prim. dr. Abdulah Nakaš "Sarajevo", Sarajevo, Bosnia and Herzegovina.
authors.forename: Haris
authors.initials: H
authors.lastname: Pandza
authors.affiliation: Surgery clinic, University Clinical Center, Tuzla, Tuzla, Bosnia and Herzegovina.
authors.forename: Sefik
authors.initials: S
authors.lastname: Hasukic
authors.affiliation: General Hospital "Prim. dr. Abdulah Nakaš "Sarajevo", Sarajevo, Bosnia and Herzegovina.
authors.forename: Samir
authors.initials: S
authors.lastname: Custovic
authors.affiliation: Faculty of medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Berina
authors.initials: B
authors.lastname: Pandza
authors.affiliation: General Hospital "Prim. dr. Abdulah Nakaš "Sarajevo", Sarajevo, Bosnia and Herzegovina.
authors.forename: Amina
authors.initials: A
authors.lastname: Krupalija
authors.affiliation: General Hospital "Prim. dr. Abdulah Nakaš "Sarajevo", Sarajevo, Bosnia and Herzegovina.
authors.forename: Edin
authors.initials: E
authors.lastname: Beciragic
mesh_terms: D019840:2-Propanol / Q000494:pharmacology / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use*; D000431:Ethanol / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000494:pharmacology / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol; D011206:Povidone-Iodine; D019840:2-Propanol
keywords: ethanol; hernia repair; povidone iodide; surgical site infection