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A Comparison of Chlorhexidine-Alcohol Versus Povidone-Iodine for Eliminating Skin Flora Before Genitourinary Prosthetic Surgery: A Randomized Controlled Trial

2012; Lippincott Williams & Wilkins; Volume: 189; Issue: 1 Linguagem: Inglês

10.1016/j.juro.2012.08.086

1527-3792

Lawrence L. Yeung, Shaun Grewal, Arnold Bullock, H. Henry Lai, Steven B. Brandes,

Wound Healing and Treatments

No AccessJournal of UrologyAdult Urology1 Jan 2013A Comparison of Chlorhexidine-Alcohol Versus Povidone-Iodine for Eliminating Skin Flora Before Genitourinary Prosthetic Surgery: A Randomized Controlled Trial Lawrence L. Yeung, Shaun Grewal, Arnold Bullock, H. Henry Lai, and Steven B. Brandes Lawrence L. YeungLawrence L. Yeung Department of Urology, University of Florida, Gainesville, Florida , Shaun GrewalShaun Grewal Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri , Arnold BullockArnold Bullock Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri , H. Henry LaiH. Henry Lai Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri , and Steven B. BrandesSteven B. Brandes Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri View All Author Informationhttps://doi.org/10.1016/j.juro.2012.08.086AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We defined the relevant skin flora during genitourinary prosthetic surgery, evaluated the safety of chlorhexidine-alcohol for use on the male genitalia and compared chlorhexidine-alcohol to povidone-iodine in decreasing the rate of positive bacterial skin cultures at the surgical skin site before prosthetic device implantation. Materials and Methods: In this single institution, prospective, randomized, controlled study we evaluated 100 consecutive patients undergoing initial genitourinary prosthetic implantation. Patients were randomized to a standard skin preparation with povidone-iodine or chlorhexidine-alcohol. Skin cultures were obtained from the surgical site before and after skin preparation. Results: A total of 100 patients were randomized, with 50 in each arm. Pre-preparation cultures were positive in 79% of the patients. Post-preparation cultures were positive in 8% in the chlorhexidine-alcohol group compared to 32% in the povidone-iodine group (p = 0.0091). Coagulase-negative staphylococci were the most commonly isolated organisms in post-preparation cultures in the povidone-iodine group (13 of 16 patients) as opposed to propionibacterium in the chlorhexidine-alcohol group (3 of 4 patients). Clinical complications requiring additional operations or device removal occurred in 6 patients (6%) with no significant difference between the 2 groups. No urethral or genital skin complications occurred in either group. Conclusions: Chlorhexidine-alcohol was superior to povidone-iodine in eradicating skin flora at the surgical skin site before genitourinary prosthetic implantation. 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Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLinder B, Piotrowski J, Ziegelmann M, Rivera M, Rangel L and Elliott D (2015) Perioperative Complications following Artificial Urinary Sphincter PlacementJournal of Urology, VOL. 194, NO. 3, (716-720), Online publication date: 1-Sep-2015.Seftel A (2014) Re: A Population-Based Analysis of Contemporary Rates of Reoperation for Penile Prosthesis ProceduresJournal of Urology, VOL. 192, NO. 6, (1774-1776), Online publication date: 1-Dec-2014.Katz B, Gaunay G, Barazani Y, Nelson C, Moreira D, Dinlenc C, Nagler H and Stember D (2014) Use of a Preoperative Checklist Reduces Risk of Penile Prosthesis InfectionJournal of Urology, VOL. 192, NO. 1, (130-135), Online publication date: 1-Jul-2014. Volume 189Issue 1January 2013Page: 136-140 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordspenile implantationurinary sphincter, artificialsuburethral slingspovidone-iodinechlorhexidineAcknowledgmentsLiu Yang assisted with statistical analysis.MetricsAuthor Information Lawrence L. Yeung Department of Urology, University of Florida, Gainesville, Florida Nothing to disclose. More articles by this author Shaun Grewal Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri Nothing to disclose. More articles by this author Arnold Bullock Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri Financial interest and/or other relationship with Pfizer, Astellas, American Medical Systems Inc. and Coloplast. More articles by this author H. Henry Lai Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri Financial interest and/or other relationship with Pfizer and Astellas. More articles by this author Steven B. Brandes Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri Financial interest and/or other relationship with Astellas, American Medical Systems Inc. and Allergan. More articles by this author Expand All Advertisement PDF downloadLoading ...