三种不同清洗方法的术前皮肤消毒效果对比研究

Three different preoperative cleaning methods for preoperative disinfection effect

目的对于不同清洗方法之后的术前皮肤消毒效果进行比较研究,以证明术前抗菌沐浴的必要性。方法从动物实验、皮肤现场实验、临床观察统计3个方面对3种清洗方法进行比较分析。结果使用抗菌皂液进行清洗后再消毒对于普通皮肤表面细菌和致病菌的杀灭效果对比使用肥皂水清洗组和清水冲洗组均有明显的提高。动物模拟手术实验中,抗菌皂液清洗组术后愈合过程中无感染,手术伤口均正常愈合,未出现不良反应,其他两组均有少量感染现象。人体皮肤模拟现场实验中,使用肥皂水清洗和使用抗菌皂液清洗后消毒效果均好于仅使用清水清洗后消毒的效果,抗菌皂液清洗后5h对皮肤表面细菌仍然有作用,且消毒效果最好。临床观察表明,实施术前抗菌沐浴后感染率稍有下降,由3.8%下降至0.9%。结论术前抗菌沐浴可以提高术前皮肤消毒的效果,是一种简单经济易行的降低手术部位感染率的方法。

OBJECTIVE To compare the different cleaning methods of preoperative skin disinfection effect, so as to prove the necessity of preoperative antibacterial bath. METHODS From animal experiments, skin field experiment and clinical observation statistics, three methods of cleaning were compare. RESULTS Effect of killing by using an- tibacterial soap to clean followed by disinfection for common skin bacteria and pathogenic bacteria compared with soap water clean group and wash group were significantly improved. Simulation experiments on animals, antibacte- rial soap washing group in postoperative healing could have no infection with all surgery wound normal healed and no adverse reaction occurred, and there were a small amount of infection in the other two groups. Simulation ex- periments on human skin, soap water washing and antibacterial soap washing were both better than only use clean water considering disinfection effect. The disinfection effect of antibacterial soap after 5h cleaning on the skin sur- face still had an effect, and the disinfection effect is the best. Clinical observation showed that implementation of preoperative antibiotic bath the infection rates could go down a bit, from 3.8 % to 0.9 %. CONCLUSION Preopera- tive antibiotic bath can improve the effect of preoperative skin disinfection, which is a simple economic and feasible method of reducing surgical site infection.