Influence of skin preparation on surgical site infection and lift of adhesive surgical drapes.

Objective: To determine the influence on surgical site infection (SSI) rates when using 0.7% iodophor and 74% isopropyl alcohol versus 2% chlorhexidine and 70% isopropyl alcohol. To evaluate the adherence of an iodophor-impregnated surgical incise drape when used in conjunction with 0.7% iodophor and 74% isopropyl alcohol.

Study design: Combines retrospective control and prospective data.

Sample population: This study included dogs and cats, 653 retrospective cases and 435 prospective cases, with 447 incisions.

Methods: The SSI rate of a 2% chlorhexidine and 70% isopropyl alcohol preparation was retrospectively reviewed. The prospective population received 0.7% iodophor and 74% isopropyl alcohol; risk factors for SSI were evaluated and incise drape lift was documented.

Results: A 1.8% difference in SSI between the chlorhexidine group and 0.7% iodophor and 74% isopropyl alcohol group was found (p = .25). The drape lift was 13.2%. Drape lift (p = .026), increased body weight (p = .008), and the use of glutaraldehyde for instrument sterilization (p = .055) were associated with an increased risk of SSI development.

Conclusion: The 0.7% iodophor and 74% isopropyl alcohol treatments demonstrated similar effectiveness to 2% chlorhexidine and 70% isopropyl alcohol in skin preparation. Using an iodophor-impregnated drape with 0.7% iodophor and 74% isopropyl alcohol reduced both drape lift and the risk of SSI.

Clinical significance: These findings support the combined use of an incise drape with 0.7% iodophor and 74% isopropyl alcohol preparation, provide evidence against the use of glutaraldehyde, and indicate that heavier patients have an increased risk of SSI.