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An Overview of Skin Antiseptics Used in Orthopaedic Surgery Procedures

Letzelter, Joseph MD; Hill, J. Bradford MD; Hacquebord, Jacques MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: August 15, 2019 - Volume 27 - Issue 16 - p 599-606
doi: 10.5435/JAAOS-D-18-00105
Review Article

Surgical site infections (SSIs) in orthopaedics are a common complication, with more than half a million SSIs occurring in the United States each year. SSIs can carry a notable burden for patients and physicians alike. Skin antiseptic solution plays an important role in preventing SSI. Many studies have looked at different skin antiseptic solution in preventing SSIs. Different surgical preps can decrease bacterial loads at surgical sites in varying degrees. Yet, the amount of bacterial load does not always correlate with a lower risk of infection.Chlorhexidine, for example, has been shown to cause markedly less SSIs compared with povidone-iodine prep in general surgery cases. Whereas chlorhexidine with alcohol may best work in the forefoot, iodine povacrylex with alcohol is equivalent in the spine. Conversely, joint arthroplasty SSIs were markedly decreased with a combination of preps. Because of all these differences, understanding which prep solution to use and when can be invaluable to the orthopaedic surgeons.

From the NYU Department of Orthopaedic Surgery (Dr. Letzelter and Dr. Hacquebord), and the NYU Department of Plastic Surgery (Dr. Hill), New York, NY.

Dr. Hacquebord or an immediate family member has received research or institutional support from Acumed, LCC. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Letzelter and Dr. Hill.

Copyright 2018 by the American Academy of Orthopaedic Surgeons.
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