{"title":"Efficacy of forefoot scrubbing with bristled brush during foot and ankle surgery.","authors":"Shengxuan Cao, Yuan Sun, Shirong Li, Xin Ma, Chen Wang, Xu Wang","doi":"10.1016/j.fas.2024.12.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The utility of forefoot cleaning using bristled brush has been proposed by previous studies but has not been tested in any study. The aim of the current study is to investigate the antiseptic efficacy of additional forefoot scrubbing with bristled brush after a standard 2-step preparation with alcohol and chlorhexidine in foot and ankle surgery.</p><p><strong>Methods: </strong>One hundred patients underwent foot and ankle surgery by one orthopedic surgeon were included and categorized into one of two groups of different skin preparation procedure before surgery. Group 1 is the control group which received a standard 2-step preparation with alcohol and chlorhexidine. Group 2 is the forefoot scrubbing group which received a standard preparation with alcohol and chlorhexidine and an additional forefoot scrubbing in a sterile fashion. Positive culture results and microbe species were primary outcomes. A secondary outcome was the occurrence of any surgical site infection (SSI) 12 months following surgery.</p><p><strong>Results: </strong>The hallux nail fold positive rate of the forefoot scrubbing group was significantly lower than that of the control group after draping (forefoot scrubbing group, 0 %; control group, 12 %; p = 0.027) and after surgery (forefoot scrubbing group, 6 %; control group, 28 %; p = 0.003). The microbe species of hallux nail fold after surgery included Staphylococcus, coagulase negative, Staphylococcus aureus, Staphylococcus epidermidis, Micrococcus luteus, Neisseria, and Corynebacterium afermentans. There was no difference in the rate of SSI between the forefoot scrubbing group (10 %) and the control group (6 %).</p><p><strong>Conclusion: </strong>Forefoot scrubbing with bristled brush before foot and ankle surgery reduces microbe growth rate after draping and after surgery at hallux nail fold.</p><p><strong>Level of evidence: </strong>Level II, prospective cohort study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot and Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.fas.2024.12.001","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
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Abstract
Background: The utility of forefoot cleaning using bristled brush has been proposed by previous studies but has not been tested in any study. The aim of the current study is to investigate the antiseptic efficacy of additional forefoot scrubbing with bristled brush after a standard 2-step preparation with alcohol and chlorhexidine in foot and ankle surgery.
Methods: One hundred patients underwent foot and ankle surgery by one orthopedic surgeon were included and categorized into one of two groups of different skin preparation procedure before surgery. Group 1 is the control group which received a standard 2-step preparation with alcohol and chlorhexidine. Group 2 is the forefoot scrubbing group which received a standard preparation with alcohol and chlorhexidine and an additional forefoot scrubbing in a sterile fashion. Positive culture results and microbe species were primary outcomes. A secondary outcome was the occurrence of any surgical site infection (SSI) 12 months following surgery.
Results: The hallux nail fold positive rate of the forefoot scrubbing group was significantly lower than that of the control group after draping (forefoot scrubbing group, 0 %; control group, 12 %; p = 0.027) and after surgery (forefoot scrubbing group, 6 %; control group, 28 %; p = 0.003). The microbe species of hallux nail fold after surgery included Staphylococcus, coagulase negative, Staphylococcus aureus, Staphylococcus epidermidis, Micrococcus luteus, Neisseria, and Corynebacterium afermentans. There was no difference in the rate of SSI between the forefoot scrubbing group (10 %) and the control group (6 %).
Conclusion: Forefoot scrubbing with bristled brush before foot and ankle surgery reduces microbe growth rate after draping and after surgery at hallux nail fold.
Level of evidence: Level II, prospective cohort study.
期刊介绍：
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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