The Experts below are selected from a list of 16920 Experts worldwide ranked by ideXlab platform
Michael J. Botte - One of the best experts on this subject based on the ideXlab platform.
-
Efficacy of Surgical Preparation solutions in foot and ankle surgery.
The Journal of bone and joint surgery. American volume, 2005Co-Authors: Roger V. Ostrander, Michael J. Botte, Michael E. BrageAbstract:Background: Previous studies have demonstrated higher infection rates following orthopaedic procedures on the foot and ankle as compared with procedures involving other areas of the body. Previous studies also have documented the difficulty of eliminating bacteria from the forefoot prior to surgery. The purpose of the present study was to evaluate the efficacy of three different Surgical skin-Preparation solutions in eliminating potential bacterial pathogens from the foot. Methods: A prospective study was undertaken to evaluate 125 consecutive patients undergoing surgery of the foot and ankle. Each lower extremity was prepared with one of three randomly selected solutions: DuraPrep (0.7% iodine and 74% isopropyl alcohol), Techni-Care (3.0% chloroxylenol), or ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol). After Preparation, quantitative culture specimens were obtained from three locations: the hallux nailfold (the hallux site), the web spaces between the second and third and between the fourth and fifth digits (the toe site), and the anterior part of the tibia (the control site). Results: In the Techni-Care group, bacteria grew on culture of specimens obtained from 95% of the hallux sites, 98% of the toe sites, and 35% of the control sites. In the DuraPrep group, bacteria grew on culture of specimens obtained from 65% of the hallux sites, 45% of the toe sites, and 23% of the control sites. In the ChloraPrep group, bacteria grew on culture of specimens from 30% of the hallux sites, 23% of the toe sites, and 10% of the control sites. ChloraPrep was the most effective agent for eliminating bacteria from the halluces and the toes (p < 0.0001). Conclusions: The use of effective preoperative Preparation solution is an important step in limiting Surgical wound contamination and preventing infection, particularly in foot and ankle surgery. Of the three solutions tested in the present study, the combination of chlorhexidine and alcohol (ChloraPrep) was most effective for eliminating bacteria from the forefoot prior to surgery. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
-
Bacterial skin contamination after Surgical Preparation in foot and ankle surgery.
Clinical orthopaedics and related research, 2003Co-Authors: Roger V. Ostrander, Michael E. Brage, Michael J. BotteAbstract:An effective preSurgical Preparation is an important step in limiting Surgical wound contamination and preventing infection. The purpose of this study was to evaluate residual bacterial skin contamination after Surgical skin Preparation in foot and ankle surgery to determine if current techniques are satisfactory in eliminating harmful pathogens. Fifty consecutive patients having Surgical procedures of the foot and ankle were studied. Each lower extremity was prepared randomly with either a one-step povidone-iodine topical gel or a two-step iodophor scrub followed by a povidone-iodine paint. After Preparation and draping, cultures were obtained at three locations: the hallux nailfold, web space between the second and third, and fourth and fifth toes, and the anterior ankle (control). In the gel group, positive cultures were obtained from 76% of halluces, 68% of toes, and 16% of controls. In the scrub and paint group, positive cultures were obtained from 84% of halluces, 76% of toes, and 28% of controls. Numerous pathogens were cultured, with Staphylococcus epidermidis being the most prevalent. Based on the findings of the current study, preSurgical skin Preparation with a povidone-iodine based topical bactericidal agent is not sufficient in eliminating pathogens in foot and ankle surgery. The unique environment of the foot and its resident organisms may play a role in the higher infection rates associated with surgery of the foot and ankle.
Matthew D. Saltzman - One of the best experts on this subject based on the ideXlab platform.
-
The effect of axillary hair on Surgical antisepsis around the shoulder.
Journal of shoulder and elbow surgery, 2014Co-Authors: Geoffrey S. Marecek, Brian M. Weatherford, Eric B. Fuller, Matthew D. SaltzmanAbstract:Background Infection after shoulder surgery can have devastating consequences. Recent literature has implicated Propionibacterium acnes as a causative agent for postoperative shoulder infections. Axillary hair removal has been suggested as a method for infection prevention, although data quantifying its effect on the bacterial load around the shoulder are lacking. Methods We clipped one randomly selected axilla in 85 healthy male volunteers with commercially available Surgical clippers. Aerobic and anaerobic culture specimens were taken from the clipped and unclipped axillae. Each shoulder was then prepared with 2% chlorhexidine gluconate and 70% isopropyl alcohol. Repeated culture specimens were then taken from both axillae. Cultures were held for 14 days and recorded with a semiquantitative system (0-4 points). Results were compared by the Wilcoxon signed rank test. Results There was no difference in the burden of P. acnes between the clipped and unclipped axillae before or after Surgical Preparation ( P = .109, P = .344, respectively). There was a significantly greater bacterial burden in the clipped shoulder compared with the unclipped shoulder before Preparation ( P P = .285). There was a significant reduction in total bacterial load and P. acnes load for both axillae after Surgical Preparation ( P Conclusions Removal of axillary hair has no effect on the burden of P. acnes in the axilla. Clipped axillae had a higher total bacterial burden. A 2% chlorhexidine gluconate Surgical Preparation is effective at removal of all bacteria and specifically P. acnes from the axilla.
-
Efficacy of Surgical Preparation solutions in shoulder surgery.
The Journal of bone and joint surgery. American volume, 2009Co-Authors: Matthew D. Saltzman, Gordon M Nuber, Stephen M. Gryzlo, Geoffrey S. Marecek, Jason L. KohAbstract:Background Deep infection following shoulder surgery is a rare but devastating problem. The use of an effective skin-Preparation solution may be an important step in preventing infection. The purposes of the present study were to examine the native bacteria around the shoulder and to determine the efficacy of three different Surgical skin-Preparation solutions on the eradication of bacteria from the shoulder. Methods A prospective study was undertaken to evaluate 150 consecutive patients undergoing shoulder surgery at one institution. Each shoulder was prepared with one of three randomly selected solutions: ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol), DuraPrep (0.7% iodophor and 74% isopropyl alcohol), or povidone-iodine scrub and paint (0.75% iodine scrub and 1.0% iodine paint). Aerobic and anaerobic cultures were obtained prior to skin Preparation for the first twenty patients, to determine the native bacteria around the shoulder, and following skin Preparation for all patients. Results Coagulase-negative Staphylococcus and Propionibacterium acnes were the most commonly isolated organisms prior to skin Preparation. The overall rate of positive cultures was 31% in the povidone-iodine group, 19% in the DuraPrep group, and 7% in the ChloraPrep group. The positive culture rate for the ChloraPrep group was lower than that for the povidone-iodine group (p Conclusions ChloraPrep is more effective than DuraPrep and povidone-iodine at eliminating overall bacteria from the shoulder region. Both ChloraPrep and DuraPrep are more effective than povidone-iodine at eliminating coagulase-negative Staphylococcus from the shoulder.
Michael E. Brage - One of the best experts on this subject based on the ideXlab platform.
-
Efficacy of Surgical Preparation solutions in foot and ankle surgery.
The Journal of bone and joint surgery. American volume, 2005Co-Authors: Roger V. Ostrander, Michael J. Botte, Michael E. BrageAbstract:Background: Previous studies have demonstrated higher infection rates following orthopaedic procedures on the foot and ankle as compared with procedures involving other areas of the body. Previous studies also have documented the difficulty of eliminating bacteria from the forefoot prior to surgery. The purpose of the present study was to evaluate the efficacy of three different Surgical skin-Preparation solutions in eliminating potential bacterial pathogens from the foot. Methods: A prospective study was undertaken to evaluate 125 consecutive patients undergoing surgery of the foot and ankle. Each lower extremity was prepared with one of three randomly selected solutions: DuraPrep (0.7% iodine and 74% isopropyl alcohol), Techni-Care (3.0% chloroxylenol), or ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol). After Preparation, quantitative culture specimens were obtained from three locations: the hallux nailfold (the hallux site), the web spaces between the second and third and between the fourth and fifth digits (the toe site), and the anterior part of the tibia (the control site). Results: In the Techni-Care group, bacteria grew on culture of specimens obtained from 95% of the hallux sites, 98% of the toe sites, and 35% of the control sites. In the DuraPrep group, bacteria grew on culture of specimens obtained from 65% of the hallux sites, 45% of the toe sites, and 23% of the control sites. In the ChloraPrep group, bacteria grew on culture of specimens from 30% of the hallux sites, 23% of the toe sites, and 10% of the control sites. ChloraPrep was the most effective agent for eliminating bacteria from the halluces and the toes (p < 0.0001). Conclusions: The use of effective preoperative Preparation solution is an important step in limiting Surgical wound contamination and preventing infection, particularly in foot and ankle surgery. Of the three solutions tested in the present study, the combination of chlorhexidine and alcohol (ChloraPrep) was most effective for eliminating bacteria from the forefoot prior to surgery. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
-
Bacterial skin contamination after Surgical Preparation in foot and ankle surgery.
Clinical orthopaedics and related research, 2003Co-Authors: Roger V. Ostrander, Michael E. Brage, Michael J. BotteAbstract:An effective preSurgical Preparation is an important step in limiting Surgical wound contamination and preventing infection. The purpose of this study was to evaluate residual bacterial skin contamination after Surgical skin Preparation in foot and ankle surgery to determine if current techniques are satisfactory in eliminating harmful pathogens. Fifty consecutive patients having Surgical procedures of the foot and ankle were studied. Each lower extremity was prepared randomly with either a one-step povidone-iodine topical gel or a two-step iodophor scrub followed by a povidone-iodine paint. After Preparation and draping, cultures were obtained at three locations: the hallux nailfold, web space between the second and third, and fourth and fifth toes, and the anterior ankle (control). In the gel group, positive cultures were obtained from 76% of halluces, 68% of toes, and 16% of controls. In the scrub and paint group, positive cultures were obtained from 84% of halluces, 76% of toes, and 28% of controls. Numerous pathogens were cultured, with Staphylococcus epidermidis being the most prevalent. Based on the findings of the current study, preSurgical skin Preparation with a povidone-iodine based topical bactericidal agent is not sufficient in eliminating pathogens in foot and ankle surgery. The unique environment of the foot and its resident organisms may play a role in the higher infection rates associated with surgery of the foot and ankle.
Roger V. Ostrander - One of the best experts on this subject based on the ideXlab platform.
-
Efficacy of Surgical Preparation solutions in foot and ankle surgery.
The Journal of bone and joint surgery. American volume, 2005Co-Authors: Roger V. Ostrander, Michael J. Botte, Michael E. BrageAbstract:Background: Previous studies have demonstrated higher infection rates following orthopaedic procedures on the foot and ankle as compared with procedures involving other areas of the body. Previous studies also have documented the difficulty of eliminating bacteria from the forefoot prior to surgery. The purpose of the present study was to evaluate the efficacy of three different Surgical skin-Preparation solutions in eliminating potential bacterial pathogens from the foot. Methods: A prospective study was undertaken to evaluate 125 consecutive patients undergoing surgery of the foot and ankle. Each lower extremity was prepared with one of three randomly selected solutions: DuraPrep (0.7% iodine and 74% isopropyl alcohol), Techni-Care (3.0% chloroxylenol), or ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol). After Preparation, quantitative culture specimens were obtained from three locations: the hallux nailfold (the hallux site), the web spaces between the second and third and between the fourth and fifth digits (the toe site), and the anterior part of the tibia (the control site). Results: In the Techni-Care group, bacteria grew on culture of specimens obtained from 95% of the hallux sites, 98% of the toe sites, and 35% of the control sites. In the DuraPrep group, bacteria grew on culture of specimens obtained from 65% of the hallux sites, 45% of the toe sites, and 23% of the control sites. In the ChloraPrep group, bacteria grew on culture of specimens from 30% of the hallux sites, 23% of the toe sites, and 10% of the control sites. ChloraPrep was the most effective agent for eliminating bacteria from the halluces and the toes (p < 0.0001). Conclusions: The use of effective preoperative Preparation solution is an important step in limiting Surgical wound contamination and preventing infection, particularly in foot and ankle surgery. Of the three solutions tested in the present study, the combination of chlorhexidine and alcohol (ChloraPrep) was most effective for eliminating bacteria from the forefoot prior to surgery. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
-
Bacterial skin contamination after Surgical Preparation in foot and ankle surgery.
Clinical orthopaedics and related research, 2003Co-Authors: Roger V. Ostrander, Michael E. Brage, Michael J. BotteAbstract:An effective preSurgical Preparation is an important step in limiting Surgical wound contamination and preventing infection. The purpose of this study was to evaluate residual bacterial skin contamination after Surgical skin Preparation in foot and ankle surgery to determine if current techniques are satisfactory in eliminating harmful pathogens. Fifty consecutive patients having Surgical procedures of the foot and ankle were studied. Each lower extremity was prepared randomly with either a one-step povidone-iodine topical gel or a two-step iodophor scrub followed by a povidone-iodine paint. After Preparation and draping, cultures were obtained at three locations: the hallux nailfold, web space between the second and third, and fourth and fifth toes, and the anterior ankle (control). In the gel group, positive cultures were obtained from 76% of halluces, 68% of toes, and 16% of controls. In the scrub and paint group, positive cultures were obtained from 84% of halluces, 76% of toes, and 28% of controls. Numerous pathogens were cultured, with Staphylococcus epidermidis being the most prevalent. Based on the findings of the current study, preSurgical skin Preparation with a povidone-iodine based topical bactericidal agent is not sufficient in eliminating pathogens in foot and ankle surgery. The unique environment of the foot and its resident organisms may play a role in the higher infection rates associated with surgery of the foot and ankle.
Jason L. Koh - One of the best experts on this subject based on the ideXlab platform.
-
Efficacy of Surgical Preparation solutions in shoulder surgery.
The Journal of bone and joint surgery. American volume, 2009Co-Authors: Matthew D. Saltzman, Gordon M Nuber, Stephen M. Gryzlo, Geoffrey S. Marecek, Jason L. KohAbstract:Background Deep infection following shoulder surgery is a rare but devastating problem. The use of an effective skin-Preparation solution may be an important step in preventing infection. The purposes of the present study were to examine the native bacteria around the shoulder and to determine the efficacy of three different Surgical skin-Preparation solutions on the eradication of bacteria from the shoulder. Methods A prospective study was undertaken to evaluate 150 consecutive patients undergoing shoulder surgery at one institution. Each shoulder was prepared with one of three randomly selected solutions: ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol), DuraPrep (0.7% iodophor and 74% isopropyl alcohol), or povidone-iodine scrub and paint (0.75% iodine scrub and 1.0% iodine paint). Aerobic and anaerobic cultures were obtained prior to skin Preparation for the first twenty patients, to determine the native bacteria around the shoulder, and following skin Preparation for all patients. Results Coagulase-negative Staphylococcus and Propionibacterium acnes were the most commonly isolated organisms prior to skin Preparation. The overall rate of positive cultures was 31% in the povidone-iodine group, 19% in the DuraPrep group, and 7% in the ChloraPrep group. The positive culture rate for the ChloraPrep group was lower than that for the povidone-iodine group (p Conclusions ChloraPrep is more effective than DuraPrep and povidone-iodine at eliminating overall bacteria from the shoulder region. Both ChloraPrep and DuraPrep are more effective than povidone-iodine at eliminating coagulase-negative Staphylococcus from the shoulder.
