Volume 32, Issue 3 (Avicenna Journal of Clinical Medicine-Autumn 2025)
Avicenna J Clin Med 2025, 32(3): 155-163 |
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Avazbakhsh Gadaneh M H, Mansouri M A, Mirhosseini S J, Sadeh M. Comparison of the Effects of Two Skin Preparation Methods, with 10% Povidone Iodine alone and the Sequence of 10% Povidone Iodine Followed by 70% Ethanol, on the Microbial Load and Mass of the Surgical Site in Candidates for Open-Heart Surgery. Avicenna J Clin Med 2025; 32 (3) :155-163
URL: http://sjh.umsha.ac.ir/article-1-3182-en.html
URL: http://sjh.umsha.ac.ir/article-1-3182-en.html
Mohammad Hossein Avazbakhsh Gadaneh1 
, Mohammad Ali Mansouri2 , Seyed Jalil Mirhosseini3 , Maryam Sadeh4
, Mohammad Ali Mansouri2 , Seyed Jalil Mirhosseini3 , Maryam Sadeh4
1- Department of Operating Room and Anesthesia, School of Paramedical, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- School of Paramedical, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Department of Surgery, School of Medicine Yazd Cardiovascular Research Center Afshar Heart Center Shahid Sadoughi University of Medical Sciences
4- Department of Laboratory Sciences, Hematology and Blood Bank, School of Paramedical, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,sadeh_m20@yahoo.com
2- School of Paramedical, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Department of Surgery, School of Medicine Yazd Cardiovascular Research Center Afshar Heart Center Shahid Sadoughi University of Medical Sciences
4- Department of Laboratory Sciences, Hematology and Blood Bank, School of Paramedical, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,
Abstract: (54 Views)
Background and Objective: Infection of the open-heart surgery site is one of the most common complications of hospital-acquired infections, which can lead to prolonged hospitalization, increased treatment costs, and higher patient mortality rates. The present study aimed to compare the effect of two skin preparation methods: 10% povidone-iodine alone versus sequential 10% povidone-iodine followed by 70% ethanol on the microbial load and burden at the surgical site in patients scheduled for open-heart surgery.
Materials and Methods: This randomized clinical trial was conducted in 2020 on 90 volunteers for open-heart surgery (two groups of 45 patients each) at Afshar Hospital in Yazd, Iran. Inclusion criteria were the absence of active infection, no systemic antibiotic use within 72 hours before surgery, and no allergy to iodine or alcohol. For each patient, skin sampling of the surgical area was performed at three time points (before preparation, after antiseptic application, and from the wound depth at the end of surgery). Sampling was performed by trained surgical staff in the operating room, according to infection-control protocols, and specimens were cultured and identified in the microbiology laboratory. Data were analyzed using SPSS software (version 19) and the Chi-square, Fisher’s exact, Friedman, and Mann–Whitney tests, with a significance level set at 0.05.
Results: In both groups, the mean microbial load was significantly reduced after skin preparation compared to baseline (P<0.05). In the 10% povidone-iodine group, all cultures were negative at the end of surgery. In the combination group, the reduction trend was similar, with no statistically significant difference between the two methods (P>0.05).
Conclusion: Both 10% povidone-iodine and the combination of 10% povidone-iodine with 70% ethanol were equally effective in reducing microbial load at the open-heart surgery site, with no significant difference between them. Depending on resource availability, cost, and patient conditions, either method can be used as a practical approach to skin preparation.
Materials and Methods: This randomized clinical trial was conducted in 2020 on 90 volunteers for open-heart surgery (two groups of 45 patients each) at Afshar Hospital in Yazd, Iran. Inclusion criteria were the absence of active infection, no systemic antibiotic use within 72 hours before surgery, and no allergy to iodine or alcohol. For each patient, skin sampling of the surgical area was performed at three time points (before preparation, after antiseptic application, and from the wound depth at the end of surgery). Sampling was performed by trained surgical staff in the operating room, according to infection-control protocols, and specimens were cultured and identified in the microbiology laboratory. Data were analyzed using SPSS software (version 19) and the Chi-square, Fisher’s exact, Friedman, and Mann–Whitney tests, with a significance level set at 0.05.
Results: In both groups, the mean microbial load was significantly reduced after skin preparation compared to baseline (P<0.05). In the 10% povidone-iodine group, all cultures were negative at the end of surgery. In the combination group, the reduction trend was similar, with no statistically significant difference between the two methods (P>0.05).
Conclusion: Both 10% povidone-iodine and the combination of 10% povidone-iodine with 70% ethanol were equally effective in reducing microbial load at the open-heart surgery site, with no significant difference between them. Depending on resource availability, cost, and patient conditions, either method can be used as a practical approach to skin preparation.
Type of Study: Original |
Subject:
Cardiovascular Surgery
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