Feasibility and Safety of Utilizing Air Ultrafine Bubble Water for Preoperative Skin Cleaning Before Foot and Ankle Surgery.

Objective: The surgical site infection (SSI) rate is reportedly higher with foot and ankle surgeries than with other parts. This is problematic for rheumatoid arthritis and diabetes mellitus patients. Ultrafine bubble (UFB) technology is expected to elongate the duration for which the surgical site can remain disinfected, thanks to its stable nanobubble structure and disinfection effects by its own radical actions. This study evaluated the feasibility and safety of preoperative skin cleaning utilizing UFB water before foot/ankle surgery.

Methods: This observational study retrospectively examined 219 extremities in 217 patients who had undergone foot/ankle surgery. Preoperative skin cleaning was performed using either conventional alcohol (concentration 80%) (conventional group; 113 extremities) or 500 mL of UFB water and conventional alcohol (UFB group; 106 extremities). Frequencies of postoperative events such as blister formation, eschar formation (width >10 mm) on the wound, and wound dehiscence after suture removal were compared, as was the time until suture removal.

Results: Rates of eschar formation and wound dehiscence after suture removal were significantly reduced in the UFB group. Time to suture removal was significantly shorter in the UFB group (12.9 d) than in the conventional group (15.5 d). All 3 cases with infected open wounds in the UFB water group achieved complete cure with wound closure within 2 weeks.

Conclusions: Preoperative skin cleaning using air UFB water appears safe and might help prevent eschar formation and wound dehiscence after foot/ankle surgeries. These effects could improve wound healing for patients undergoing foot and ankle surgery.