Daryl S. Paulson

Efficacy evaluaton of a 4% chlorhexidine gluconate as a full-body shower wash

A 4% chlorhexidine gluconate (Xttrium Laboratories, Chicago, Ill.) was used in a shower bath application to evaluate its merits in reducing resident skin microorganisms. Five volunteers completed a 14-day microbial stabilization period, a 7-day baseline period, and a 5-day test period. Subjects followed a standard protocol, performed five shower washes and were sampled at both the abdominal and inguinal regions immediately after the shower wash as well as at 3 and 6 hours later on days 1, 2, and 5. Chlorhexidine gluconate provided significant microbial reductions from baseline, with greater reductions noted as the study progressed. Use of chlorhexidine gluconate in a shower wash application in conjunction with a preoperative skin-preparation procedure may reduce the probability of surgically associated infections.

A close look at alcohol gel as an antimicrobial sanitizing agent

BACKGROUND Hand transmission of microbes by health care workers is a primary cause of nosocomial infections in both long-term and acute care facilities. Compliance with effective handwashing and hand sanitization regimens can break this cycle. METHODS We investigated the antimicrobial efficacy and irritation potential of 5 handwash product regimens: a nonantimicrobial lotion soap, an antimicrobial lotion soap, an alcohol gel sanitizer, a nonantimicrobial lotion soap with an alcohol gel sanitizer, and an antimicrobial lotion soap with an alcohol gel sanitizer. The regimens were evaluated by using a Healthcare Personnel Handwash procedure, and irritation was assessed by using expert hand evaluation after 25 consecutive washes. RESULTS The Healthcare Personnel Handwash data showed that the mean log reductions from baseline were greatest for the lotion soaps with alcohol gel sanitizer, less for the alcohol and the antimicrobial soap alone, and least for the bland soap. All of the product regimens showed a low potential for skin irritation. CONCLUSION In terms of both microorganism reduction and skin irritation, the most effective product regimens were the use of alcohol gel sanitizer in combination with either an antimicrobial or a plain lotion soap.

Efficacy and safety of a novel skin cleansing formulation versus chlorhexidine gluconate

Background: This study evaluated whether a multi‐ingredient surfactant colloidal silver technology was noninferior to a 4% chlorhexidine gluconate (CHG) antiseptic on immediate and persistent antimicrobial activity. Methods: The inguinal regions of 81 healthy adults were demarcated into 4 quadrants, and 3 were used for testing each product at baseline, 10 minutes, and 6 hours postapplication. The log of the number of colony forming units was obtained using a cylinder sampling technique. The 95% confidence interval of the test product to the control product with a margin of 0.65 was established as the upper limit of noninferiority. Results: A total of 81 individuals were enrolled. The colloidal silver product was found to be noninferior to 4% CHG at both 10 minutes and 6 hours postapplication. Conclusions: The colloidal silver‐based product was noninferior to the 4% CHG product at 10 minutes and 6 hours postapplication.

Evaluation of the Lower Flammability Limit of 70% Isopropyl Alcohol Simulating Surgical Use of a Preoperative Preparation

Objective: The ECRI Institute (formerly known as Emergency Care Research Institute) named surgical fires as one of the top 10 healthcare technology hazards for 2011. In their guide for surgical fire prevention they estimate that between 550 and 650 surgical fires occur in the United States every year, with 20 to 30 patients experiencing severe outcomes. A potentially flammable situation can occur if three essential components are present: fuel, oxygen, and an ignition source. All three components are readily available in the surgical suite and, when combined in sufficient quantities, can produce a substantial hazard in the form of fire or explosion. Fuel concentrations lower than the defined flammability limits are nonflammable. The point at which isopropyl alcohol (IPA) is considered flammable is 25% of the lower flammability limit (LFL). The purpose of this study was to identify the vapor concentration at which 70% IPA supports a flammable atmospheric situation at ambient oxygen levels in a surgical suite.