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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-10-2018 | Trauma Surgery

Preoperative disinfection of foot and ankle: microbiological evaluation of two disinfection methods

Authors: Siem A. Dingemans, Ingrid J. B. Spijkerman, Merel F. N. Birnie, J. Carel Goslings, Tim Schepers

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2018

Abstract

Background

The aim of the current study was to investigate the effect of a footbath in alcohol prior to preoperative disinfection on bacterial flora of the foot and ankle.

Methods

Twenty-two volunteers underwent skin preparation mimicking pre-surgical disinfection. One foot was submerged in a bag filled with 70% ethanol containing 10% IPA for 5 min after which it was painted with regular 0.5% chlorhexidine in 70% alcohol. The other foot was only painted with 0.5% chlorhexidine in 70% alcohol. Swabs were taken at four locations: (1) under the nailfold of the first toe, (2) first webspace, (3) sinus tarsi and (4) pre-tibial. A quantitative and qualitative analysis of the cultures was performed.

Results

No statistically significant difference between the number of positive cultures between the two methods was observed. The number of colony forming units was statistically significantly lower on two locations in the footbath group (i.e., subungual and the first webspace) (median 1 versus median 92 p =0.03 and median 0 versus median 1 p =0.03, respectively). The number of cultures with heavy growth was lower in the footbath group under the nailfold of the first toe (5 versus 13 p =0.008). Thirty-eight different microorganisms were cultured.

Conclusion

A footbath in alcohol prior to regular preoperative skin antisepsis significantly reduces the amount of bacteria under the nailfold and in the first webspace. The number of cultures with heavy growth is lower after a footbath in alcohol.

Level of evidence

IV.

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Title: Preoperative disinfection of foot and ankle: microbiological evaluation of two disinfection methods
Authors: Siem A. Dingemans
Ingrid J. B. Spijkerman
Merel F. N. Birnie
J. Carel Goslings
Tim Schepers
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2996-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preoperative disinfection of foot and ankle: microbiological evaluation of two disinfection methods

Abstract

Background

Methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of evidence

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