The Experts below are selected from a list of 111 Experts worldwide ranked by ideXlab platform

J Stuart - One of the best experts on this subject based on the ideXlab platform.

  • Surgical hand antisepsis to reduce surgical site infection.
    The Cochrane database of systematic reviews, 2008
    Co-Authors: J Tanner, S Swarbrook, J Stuart
    Abstract:

    Surgical hand antisepsis, to destroy transient micro-organisms and inhibit the growth of resident micro-organisms, is routinely carried out before undertaking invasive procedures. Antisepsis may reduce the risk of surgical site infections in patients. To determine the effects of surgical hand antisepsis on the number of surgical site infections (SSIs) in patients. The secondary objective is to determine the effects of surgical hand antisepsis on the numbers of colony forming units (CFUs) of bacteria on the hands of the surgical team. We searched the Cochrane Wounds Group Specialised Register (June 2007), the Cochrane Central Register of Controlled Trials (Issue 2, 2007), MEDLINE (Week 5, 2007), CINAHL (June 2007), EMBASE (Week 23, 2007) and ZETOC (2005). Randomised controlled trials comparing surgical hand antisepsis of varying duration, methods and antiseptic solutions. Three authors independently assessed studies for selection, trial quality and extracted data. Ten trials were included in this review. Only one trial reported the primary outcome, rates of SSIs, and nine trials measured numbers of CFUs. One trial involving 4387 patients found alcohol rubs with additional active ingredients were as effective as Aqueous scrubs in reducing SSIs. Four trials compared different alcohol rubs containing additional active ingredients with Aqueous scrubs for numbers of CFUs on hands. One trial found N-duopropenide more effective than chlorhexidine and povidone Iodine Aqueous scrubs. One trial found 45% propanol-2, 30% propanol-1 with 0.2% ethylhexadecyldimethyl ammonium ethylsulfate more effective than chlorhexidine scrubs. One trial found no difference between 1% chlorhexidine gluconate in 61% ethyl alcohol or zinc pyrithione in 70% ethyl alcohol against Aqueous povidone Iodine. A fourth trial found 4% chlorhexidine gluconate scrubs more effective than chlorhexidine in 70% alcohol rubs. Four trials compared the relative effects of different Aqueous scrubs in reducing CFUs on hands. Three trials found chlorhexidine gluconate scrubs were significantly more effective than povidone Iodine scrubs. One trial found no difference between chlorhexidine gluconate scrubs and povidone Iodine plus triclosan scrubs. Two trials found no evidence of a difference between alternative alcohol rubs in terms of the number of CFUs. Four trials compared the effect of different durations of scrubs and rubs on the numbers of CFUs on hands. One trial found no difference after the initial scrub but found subsequent three minute scrubs using chlorhexidine significantly more effective than subsequent scrubs lasting 30 seconds. One trial found that following a one minute hand wash, a three minute rub appears to be more effective than the five minute rub using alcohol disinfectant. The other comparisons demonstrated no difference. Alcohol rubs used in preparation for surgery by the scrub team are as effective as Aqueous scrubbing in preventing SSIs however this evidence comes from only one, equivalence, cluster trial which did not appear to adjust for clustering. Four comparisons suggest that alcohol rubs are at least as, if not more, effective than Aqueous scrubs though the quality of these is mixed and each study presents a different comparison, precluding meta analysis. There is no evidence to suggest that any particular alcohol rub is better than another. Evidence from 4 studies suggests that chlorhexidine gluconate based Aqueous scrubs are more effective than povidone Iodine based Aqueous scrubs in terms of the numbers of CFUs on the hands. There is limited evidence regarding the effects on CFUs numbers of different scrub durations. There is no evidence regarding the effect of equipment such as brushes and sponges.

J Tanner - One of the best experts on this subject based on the ideXlab platform.

  • Surgical hand antisepsis to reduce surgical site infection.
    The Cochrane database of systematic reviews, 2008
    Co-Authors: J Tanner, S Swarbrook, J Stuart
    Abstract:

    Surgical hand antisepsis, to destroy transient micro-organisms and inhibit the growth of resident micro-organisms, is routinely carried out before undertaking invasive procedures. Antisepsis may reduce the risk of surgical site infections in patients. To determine the effects of surgical hand antisepsis on the number of surgical site infections (SSIs) in patients. The secondary objective is to determine the effects of surgical hand antisepsis on the numbers of colony forming units (CFUs) of bacteria on the hands of the surgical team. We searched the Cochrane Wounds Group Specialised Register (June 2007), the Cochrane Central Register of Controlled Trials (Issue 2, 2007), MEDLINE (Week 5, 2007), CINAHL (June 2007), EMBASE (Week 23, 2007) and ZETOC (2005). Randomised controlled trials comparing surgical hand antisepsis of varying duration, methods and antiseptic solutions. Three authors independently assessed studies for selection, trial quality and extracted data. Ten trials were included in this review. Only one trial reported the primary outcome, rates of SSIs, and nine trials measured numbers of CFUs. One trial involving 4387 patients found alcohol rubs with additional active ingredients were as effective as Aqueous scrubs in reducing SSIs. Four trials compared different alcohol rubs containing additional active ingredients with Aqueous scrubs for numbers of CFUs on hands. One trial found N-duopropenide more effective than chlorhexidine and povidone Iodine Aqueous scrubs. One trial found 45% propanol-2, 30% propanol-1 with 0.2% ethylhexadecyldimethyl ammonium ethylsulfate more effective than chlorhexidine scrubs. One trial found no difference between 1% chlorhexidine gluconate in 61% ethyl alcohol or zinc pyrithione in 70% ethyl alcohol against Aqueous povidone Iodine. A fourth trial found 4% chlorhexidine gluconate scrubs more effective than chlorhexidine in 70% alcohol rubs. Four trials compared the relative effects of different Aqueous scrubs in reducing CFUs on hands. Three trials found chlorhexidine gluconate scrubs were significantly more effective than povidone Iodine scrubs. One trial found no difference between chlorhexidine gluconate scrubs and povidone Iodine plus triclosan scrubs. Two trials found no evidence of a difference between alternative alcohol rubs in terms of the number of CFUs. Four trials compared the effect of different durations of scrubs and rubs on the numbers of CFUs on hands. One trial found no difference after the initial scrub but found subsequent three minute scrubs using chlorhexidine significantly more effective than subsequent scrubs lasting 30 seconds. One trial found that following a one minute hand wash, a three minute rub appears to be more effective than the five minute rub using alcohol disinfectant. The other comparisons demonstrated no difference. Alcohol rubs used in preparation for surgery by the scrub team are as effective as Aqueous scrubbing in preventing SSIs however this evidence comes from only one, equivalence, cluster trial which did not appear to adjust for clustering. Four comparisons suggest that alcohol rubs are at least as, if not more, effective than Aqueous scrubs though the quality of these is mixed and each study presents a different comparison, precluding meta analysis. There is no evidence to suggest that any particular alcohol rub is better than another. Evidence from 4 studies suggests that chlorhexidine gluconate based Aqueous scrubs are more effective than povidone Iodine based Aqueous scrubs in terms of the numbers of CFUs on the hands. There is limited evidence regarding the effects on CFUs numbers of different scrub durations. There is no evidence regarding the effect of equipment such as brushes and sponges.

Brian M. Mercer - One of the best experts on this subject based on the ideXlab platform.

  • A randomized open-label controlled trial of chlorhexidine-alcohol vs povidone-Iodine for cesarean antisepsis: the CAPICA trial.
    American journal of obstetrics and gynecology, 2017
    Co-Authors: Edward Springel, Xiao-yu Wang, Vanessa Sarfoh, Bradley Stetzer, Steven Weight, Brian M. Mercer
    Abstract:

    Identification of optimal surgical site antisepsis preparations may reduce cesarean-related surgical site infections. Two recently published investigations examined efficacy of chlorhexidine-alcohol and Iodine-alcohol preparations. No previous randomized controlled trial has compared chlorhexidine-alcohol to povidone-Iodine Aqueous scrub and paint in reduction of cesarean-related surgical site infection. The purpose of the study was to determine if chlorhexidine-alcohol would result in fewer surgical site infections than povidone-Iodine when used as skin antisepsis preparation prior to cesarean delivery. This study was a single-center pragmatic randomized controlled trial at an urban tertiary care institution to compare chlorhexidine-alcohol 26-mL single-step applicator to povidone-Iodine Aqueous scrub and paint 236-mL wet skin tray as preoperative skin antiseptic preparation for women undergoing cesarean delivery. Patients were eligible for study participation if they could provide informed consent in English or Spanish, were ≥18 years of age, did not have clinical chorioamnionitis, were unlikely to be lost to follow-up, and had no sensitivities to chlorhexidine, betadine, or Iodine. Treatment was assigned by computer-generated simple 1:1 randomization immediately before skin preparation. The primary outcome was surgical site infection occurring within 30 days of cesarean delivery including ≥1 of: superficial or deep surgical site infection, or endometritis, according to Centers for Disease Control and Prevention definitions. Analysis was by intent to treat. Categorical outcomes were compared using Fisher exact test. The Wilcoxon rank-sum test was performed for continuous outcomes. This trial was institutional review board approved and registered at ClinicalTrials.gov (NCT02202577). In all, 932 subjects (461 assigned to chlorhexidine-alcohol, 471 assigned to povidone-Iodine) were randomized from February 2013 through May 2016. Rate of follow-up evaluation after 30 days was 99% (455) in the chlorhexidine-alcohol group and 97% (455) in the povidone-Iodine group. Surgical site infection occurred in 29 (6.3%) of the chlorhexidine-alcohol group and 33 (7.0%) in the povidone-Iodine group (P = .38). The rates of individual components of the primary outcome were as follows: superficial surgical site infection (4.6% v 5.5%; P = .55), deep surgical site infection (0.0% v 0.4%; P = .50), and endometritis (1.7% v 1.1%; P = .42) in chlorhexidine-alcohol vs povidone-Iodine arms, respectively. All results were similar in per protocol analysis. Preoperative antiseptic skin preparation with chlorhexidine-alcohol 26-mL single-step applicator before cesarean did not result in less frequent surgical site infection when compared with povidone-Iodine Aqueous scrub and paint 236-mL wet skin preparation tray. Povidone-Iodine should still be considered as acceptable for preoperative surgical site antisepsis for cesarean delivery. Copyright © 2017 Elsevier Inc. All rights reserved.

S Swarbrook - One of the best experts on this subject based on the ideXlab platform.

  • Surgical hand antisepsis to reduce surgical site infection.
    The Cochrane database of systematic reviews, 2008
    Co-Authors: J Tanner, S Swarbrook, J Stuart
    Abstract:

    Surgical hand antisepsis, to destroy transient micro-organisms and inhibit the growth of resident micro-organisms, is routinely carried out before undertaking invasive procedures. Antisepsis may reduce the risk of surgical site infections in patients. To determine the effects of surgical hand antisepsis on the number of surgical site infections (SSIs) in patients. The secondary objective is to determine the effects of surgical hand antisepsis on the numbers of colony forming units (CFUs) of bacteria on the hands of the surgical team. We searched the Cochrane Wounds Group Specialised Register (June 2007), the Cochrane Central Register of Controlled Trials (Issue 2, 2007), MEDLINE (Week 5, 2007), CINAHL (June 2007), EMBASE (Week 23, 2007) and ZETOC (2005). Randomised controlled trials comparing surgical hand antisepsis of varying duration, methods and antiseptic solutions. Three authors independently assessed studies for selection, trial quality and extracted data. Ten trials were included in this review. Only one trial reported the primary outcome, rates of SSIs, and nine trials measured numbers of CFUs. One trial involving 4387 patients found alcohol rubs with additional active ingredients were as effective as Aqueous scrubs in reducing SSIs. Four trials compared different alcohol rubs containing additional active ingredients with Aqueous scrubs for numbers of CFUs on hands. One trial found N-duopropenide more effective than chlorhexidine and povidone Iodine Aqueous scrubs. One trial found 45% propanol-2, 30% propanol-1 with 0.2% ethylhexadecyldimethyl ammonium ethylsulfate more effective than chlorhexidine scrubs. One trial found no difference between 1% chlorhexidine gluconate in 61% ethyl alcohol or zinc pyrithione in 70% ethyl alcohol against Aqueous povidone Iodine. A fourth trial found 4% chlorhexidine gluconate scrubs more effective than chlorhexidine in 70% alcohol rubs. Four trials compared the relative effects of different Aqueous scrubs in reducing CFUs on hands. Three trials found chlorhexidine gluconate scrubs were significantly more effective than povidone Iodine scrubs. One trial found no difference between chlorhexidine gluconate scrubs and povidone Iodine plus triclosan scrubs. Two trials found no evidence of a difference between alternative alcohol rubs in terms of the number of CFUs. Four trials compared the effect of different durations of scrubs and rubs on the numbers of CFUs on hands. One trial found no difference after the initial scrub but found subsequent three minute scrubs using chlorhexidine significantly more effective than subsequent scrubs lasting 30 seconds. One trial found that following a one minute hand wash, a three minute rub appears to be more effective than the five minute rub using alcohol disinfectant. The other comparisons demonstrated no difference. Alcohol rubs used in preparation for surgery by the scrub team are as effective as Aqueous scrubbing in preventing SSIs however this evidence comes from only one, equivalence, cluster trial which did not appear to adjust for clustering. Four comparisons suggest that alcohol rubs are at least as, if not more, effective than Aqueous scrubs though the quality of these is mixed and each study presents a different comparison, precluding meta analysis. There is no evidence to suggest that any particular alcohol rub is better than another. Evidence from 4 studies suggests that chlorhexidine gluconate based Aqueous scrubs are more effective than povidone Iodine based Aqueous scrubs in terms of the numbers of CFUs on the hands. There is limited evidence regarding the effects on CFUs numbers of different scrub durations. There is no evidence regarding the effect of equipment such as brushes and sponges.

V. Sobolik - One of the best experts on this subject based on the ideXlab platform.

  • Simultaneous wall shear rate measurements by a three segmented electrodiffusion probe and laser-Doppler-anemometry
    Experiments in Fluids, 1997
    Co-Authors: H.-w. Bewersdorff, A. Gyr, K. Hoyer, V. Sobolik
    Abstract:

    In a fully developed turbulent channel flow, the instantaneous wall shear gradient was measured simultaneously by an electrodiffusion (ED) probe and by laser-Doppler anemometry (LDA). The LDA measurements were done in the viscous sublayer and the linear velocity profile was used to calculate the instantaneous shear gradient at the wall. The electrodiffusion probe requires presence of a suitable electrolyte (e.g. an Iodine and potassium-Iodine Aqueous solution) for reduction of the species on the working electrode (cathode). This results in a concentration gradient of the ions due to the convective diffusion of the [I3]- to the cathode.

  • Simultaneous wall shear rate measurements by a three segmented electrodiffusion probe and laser-Doppler-anemometry
    Experiments in Fluids, 1997
    Co-Authors: H.-w. Bewersdorff, A. Gyr, K. Hoyer, V. Sobolik
    Abstract:

     In a fully developed turbulent channel flow, the instantaneous wall shear gradient was measured simultaneously by an electrodiffusion (ED) probe and by laser-Doppler anemometry (LDA). The LDA measurements were done in the viscous sublayer and the linear velocity profile was used to calculate the instantaneous shear gradient at the wall. The electrodiffusion probe requires presence of a suitable electrolyte (e.g. an Iodine and potassium-Iodine Aqueous solution) for reduction of the species on the working electrode (cathode). This results in a concentration gradient of the ions due to the convective diffusion of the [I_3]^- to the cathode. Due to the limited molecular diffusion rate and due to the dimension of the electrodiffusion probe its frequency resolution is limited. It is shown in which limits the correction of the signal on the concentration boundary layer inertia is not necessary and the probe can be used for measuring instantaneous wall shear gradients in turbulent flows. The results are compared with those obtained by LDA and elucidate the capability of the ED probe for measuring instantaneous shear rates at low Reynolds numbers.