Antimicrobial Activity of Iodophor and Chlorhexidine in Surgical Preparation of Skin
Journal of Pharmaceutical Research International,
Page 67-74
DOI:
10.9734/jpri/2020/v32i1930710
Abstract
An effective pre surgical Preparation is important step in preventing surgical wound contamination and post operative infection. Preparing a 100% sterile surgical environment is one of the biggest challenges of surgery. Since skin is the most common source of pathogen they make the skin preparation at the time of procedure critical. The most common skin preparation agents are iodophors and chlorhexidine. The aqueous based iodophors are, such as povidone iodine is one of the few products that can be safely used on mucous membrane. Iodophor and chlorhexidine are quick sustained and durable with broader spectrum anti microbial activity. These agents are ideal for longer open surgeries. There is a need for comparison of antimicrobial activity of iodophor and chlorhexidine. In surgical preparation of the skin. In this study we used iodophor and chlorhexidine to check their anti microbial activity in surgical preparation of skin. A square of area 10 sq cm was drawn on the surface of the skin on arm and divided into upper half and lower half.2 sterilised cotton swabs were taken and they were moistened with saline water. First swab was taken before applying the disinfectant and the second swab was taken 2 mins after applying the disinfectant. Both swabs were spread in the TSA agar. Total bacterial count was counted in the before and after swab. Iodine was used as disinfectant in 5 people and chlorhexidine was used as disinfectant in 5 people. Iodophor had a better activity against the micro organisms than that of the chlorhexidine.
Keywords:
- Antimicrobial activity
- iodophor
- chlorhexidine
- disinfectant
How to Cite
Jeyashree, T., & Muralidharan, N. P. (2020). Antimicrobial Activity of Iodophor and Chlorhexidine in Surgical Preparation of Skin. Journal of Pharmaceutical Research International, 32(19), 67-74. https://doi.org/10.9734/jpri/2020/v32i1930710
References
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Available:http://dx.doi.org/10.1556/030.65.2018.038
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Available:https://www.sciencedirect.com/science/article/pii/S1156523319300496
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Available:http://www.indianjournals.com/ijor.aspx?target=ijor:rjpt&volume=9&issue=11&article=035
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Available:http://dx.doi.org/10.1016/j.archoralbio.2018.07.001
Priyadharsini JV, Girija ASS, Paramasivam A. An insight into the emergence of Acinetobacter baumannii as an oro-dental pathogen and its drug resistance gene profile--An in silico approach. Heliyon [Internet]. 2018;4(12):e01051.
Available:https://www.sciencedirect.com/science/article/pii/S2405844018358559
Paramasivam A, Vijayashree Priyadharsini J, Raghunandhakumar S. N6-adenosine methylation (m6A): A promising new molecular target in hypertension and cardiovascular diseases. Hypertens Res [Internet]. 2020;43(2):153–4.
Available:http://dx.doi.org/10.1038/s41440-019-0338-z
Smiline ASG, Vijayashree JP, Paramasivam A. Molecular characterization of plasmid-encoded blaTEM, blaSHV and blaCTX-M among extended spectrum β-lactamases [ESBLs] producing Acinetobacter baumannii. Br J Biomed Sci [Internet]. 2018 2;75(4):200–2.
Available:https://doi.org/10.1080/09674845.2018.1492207
Marickar RF, Geetha RV, Neelakantan P. Efficacy of contemporary and novel Intracanal medicaments against Enterococcus faecalis. J Clin Pediatr Dent [Internet]. 2014;39(1):47–50.
Available:https://meridian.allenpress.com/jcpd/article-abstract/39/1/47/189335
Geetha RV, Thangavelu L, Others. Evaluation oEvaluation of anti-inflammatory action of Laurus nobilis-an in vitro studyf anti-inflammatory action of Laurus nobilis-An in vitro study. International Journal of Research in Pharmaceutical Sciences [Internet]. 2019; 10(2):1209–13.
Available:https://www.pharmascope.org/index.php/ijrps/article/view/408
Vaishali M, Geetha RV. Antibacterial activity of Orange peel oil on Streptococcus mutans and Enterococcus-An in-vitro study. Research Journal of Pharmacy and Technology [Internet]. 2018;11(2):513–4.
Available:http://www.indianjournals.com/ijor.aspx?target=ijor:rjpt&volume=11&issue=2&article=016
Neville R, Laredo J. Faculty of 1000 evaluation for chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis [Internet]. F1000 - Post-publication peer review of the biomedical literature; 2010.
Available:http://dx.doi.org/10.3410/f.1493957.1198072
Fleischer W, Reimer K. Povidone-iodine in antisepsis--state of the art. Dermatology [Internet]. 1997;195(Suppl.2):3–9.
Available:https://www.karger.com/Article/Abstract/246022
Pollack W, Iny O. Iodine-containing germicidal preparations and method of controlling germicidal activity [Internet]. US Patent. 1990;4946673.
Available:https://patentimages.storage.googleapis.com/4f/ae/3b/15d81e3eee513e/US4946673.pdf
[Cited 2020 Jun 30].
Angel DE, Morey P, Storer J, Mwipatayi BP, Others. The great debate over iodine in wound care continues: A review of the literature. Wound Practice & Research: Journal of the Australian Wound Management Association [Internet]. 2008; 16(1):6.
Available:https://search.informit.com.au/documentSummary;dn=293606395919612;res=IELHEA
Eggers M. Correction to: Infectious disease management and control with povidone iodine. Infect Dis Ther [Internet]. 2019; 8(4):595.
Available: http://dx.doi.org/10.1007/s40121-019-00263-8
Adams D, Quayum M, Worthington T, Lambert P, Elliott T. Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant. J Hosp Infect [Internet]. 2005;61(4):287–90.
Available:http://dx.doi.org/10.1016/j.jhin.2005.05.015
Da Cunha ML, Procianoy RS, Franceschini DT, De Oliveira LL, Cunha ML. Effect of the first bath with chlorhexidine on skin colonization with Staphylococcus aureus in normal healthy term newborns. Scand J Infect Dis [Internet]. 2008;40(8):615–20.
Available:http://dx.doi.org/10.1080/00365540801932447
Ison S, Beattie M. Disinfection, sterilization and preservation (5th Ed) [Internet]. Australian Infection Control. 2002;7:74.
Available:http://dx.doi.org/10.1071/hi02074
Hiom SJ, Furr JR, Russell AD, Dickinson JR. Effects of chlorhexidine diacetate on Candida albicans, C. glabrata and Saccharomyces cerevisiae. J Appl Bacteriol [Internet]. 1992;72(4):335–40.
Available:http://dx.doi.org/10.1111/j.1365-2672.1992.tb01844.x
Bhardwaj P, Hans A, Ruikar K, Guan Z, Palmer KL. Reduced chlorhexidine and daptomycin susceptibility in vancomycin-resistant Enterococcus faecium after serial chlorhexidine exposure [Internet]. Antimicrobial Agents and Chemotherapy. 2017;62.
Available:http://dx.doi.org/10.1128/aac.01235-17
Shaker LA, Dancer BN, Russell AD, Furr JR. Emergence and development of chlorhexidine resistance during sporulation of Bacillus subtilis 168. FEMS Microbiol Lett [Internet]. 1988;51(1):3–6.
Available:https://academic.oup.com/femsle/article-abstract/51/1/73/490006
[Cited 2020 Jun 30].
Shaker LA, Russell AD, Furr JR. Aspects of the action of chlorhexidine on bacterial spores. Int J Pharm [Internet]. 1986;34(1): 51–6.
Available:http://www.sciencedirect.com/science/article/pii/0378517386900098
Kaye KS. Infection Prevention and Control in the Hospital, An Issue of Infectious Disease Clinics - E-Book [Internet]. Elsevier Health Sciences; 2011;312.
Available:https://play.google.com/store/books/details?id=XeXHDDeR84sC
Hadaway LC. Skin flora and infection. J Infus Nurs [Internet]. 2003;26(1):44–8.
Available:http://dx.doi.org/10.1097/00129804-200301000-00006
Chung K-T, Rice SL, Wilson PW, Nelson PE. Sporicidal activity of hydrogen peroxide and iodophor on the spores of Clostridium sporogenes. J Food Sci [Internet]. 1979;44(4):1261–2.
Available:http://doi.wiley.com/10.1111/j.1365-2621.1979.tb03497.x
Program of Randomized Trials to Evaluate Pre-operative Antiseptic Skin Solutions in Orthopaedic Trauma (PREP-IT) Investigators, Slobogean GP, Sprague S, Wells J, Bhandari M, Rojas A, et al. effectiveness of iodophor vs chlorhexidine solutions for surgical site infections and unplanned reoperations for patients who underwent fracture repair: The PREP-IT Master Protocol. JAMA Netw Open [Internet]. 2020;3(4):e202215.
Available:http://dx.doi.org/10.1001/jamanetworkopen.2020.2215
Available:https://www.liebertpub.com/doi/abs/10.1089/sur.2015.264
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Committee HICPA, et al. Guideline for prevention of surgical site infection, Infect Control Hosp Epidemiol [Internet]. 1999;20(4):247–80.
Available:https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/guideline-for-prevention-of-surgical-site-infection-1999/31585A523649826D6497F019D0907A60
Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: Attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol [Internet]. 1999; 20(11):725–30.
Available:http://dx.doi.org/10.1086/501572
Whitehouse JD, Friedman ND, Kirkland KB, Richardson WJ, Sexton DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol [Internet]. 2002;23(4):183–9.
Available:https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/impact-of-surgicalsite-infections-following-orthopedic-surgery-at-a-community-hospital-and-a-university-hospital-adverse-quality-of-life-excess-length-of-stay-and-extra-cost/A458159DB34D8E8732490EB49FE14100
Pratha AA, Geetha RV. Awareness on hepatitis-B vaccination among dental students-A questionnaire survey. J Adv Pharm Technol Res [Internet]. 2017;10(5): 1360.
Available:http://www.indianjournals.com/ijor.aspx?target=ijor:rjpt&volume=10&issue=5&article=015
Girija As S, Priyadharsini JV. CLSI based antibiogram profile and the detection of MDR and XDR strains of Acinetobacter baumannii isolated from urine samples. Med J Islam Repub Iran [Internet]. 2019 8;33:3.
Available:http://dx.doi.org/10.34171/mjiri.33.3
Girija SA, Jayaseelan VP, Arumugam P. Prevalence of VIM- and GIM-producing Acinetobacter baumannii from patients with severe urinary tract infection. Acta Microbiol Immunol Hung [Internet]. 2018 1;65(4):539–50.
Available:http://dx.doi.org/10.1556/030.65.2018.038
Ashwin KS, Muralidharan NP. Vancomycin-resistant enterococcus (VRE) vs Methicillin-resistant Staphylococcus aureus (MRSA). Indian J Med Microbiol [Internet]. 2015;33:166–7.
Available:http://dx.doi.org/10.4103/0255-0857.150976
Girija ASS, Smiline Girija AS, Vijayashree Priyadharsini J, Paramasivam A. Plasmid-encoded resistance to trimethoprim/ sulfamethoxazole mediated by dfrA1, dfrA5, sul1 and sul2 among Acinetobacter baumannii isolated from urine samples of patients with severe urinary tract infection [Internet]. Journal of Global Antimicrobial Resistance. 2019;17: 145–6.
Available:http://dx.doi.org/10.1016/j.jgar.2019.04.001
Shahzan MS, Girija ASS, Priyadharsini JV. A computational study targeting the mutated L321F of ERG11 gene in C. albicans, associated with fluconazole resistance with bioactive compounds from Acacia nilotica. J Mycol Med [Internet]. 2019;29(4):303–9.
Available:https://www.sciencedirect.com/science/article/pii/S1156523319300496
Selvakumar R, Np M. Comparison in benefits of herbal mouthwashes with chlorhexidine mouthwash: A review [Internet]. Asian Journal of Pharmaceutical and Clinical Research. 2017;10:3.
Available:http://dx.doi.org/10.22159/ajpcr.2017.v10i2.13304
Shahana RY, Muralidharan NP. Efficacy of mouth rinse in maintaining oral health of patients attending orthodontic clinics. Research Journal of Pharmacy and Technology [Internet]. 2016;9(11):1991–3.
Available:http://www.indianjournals.com/ijor.aspx?target=ijor:rjpt&volume=9&issue=11&article=035
Priyadharsini JV, Vijayashree Priyadharsini J, Smiline Girija AS, Paramasivam A. In silico analysis of virulence genes in an emerging dental pathogen A. baumannii and related species [Internet]. Archives of Oral Biology. 2018;94:93–8.
Available:http://dx.doi.org/10.1016/j.archoralbio.2018.07.001
Priyadharsini JV, Girija ASS, Paramasivam A. An insight into the emergence of Acinetobacter baumannii as an oro-dental pathogen and its drug resistance gene profile--An in silico approach. Heliyon [Internet]. 2018;4(12):e01051.
Available:https://www.sciencedirect.com/science/article/pii/S2405844018358559
Paramasivam A, Vijayashree Priyadharsini J, Raghunandhakumar S. N6-adenosine methylation (m6A): A promising new molecular target in hypertension and cardiovascular diseases. Hypertens Res [Internet]. 2020;43(2):153–4.
Available:http://dx.doi.org/10.1038/s41440-019-0338-z
Smiline ASG, Vijayashree JP, Paramasivam A. Molecular characterization of plasmid-encoded blaTEM, blaSHV and blaCTX-M among extended spectrum β-lactamases [ESBLs] producing Acinetobacter baumannii. Br J Biomed Sci [Internet]. 2018 2;75(4):200–2.
Available:https://doi.org/10.1080/09674845.2018.1492207
Marickar RF, Geetha RV, Neelakantan P. Efficacy of contemporary and novel Intracanal medicaments against Enterococcus faecalis. J Clin Pediatr Dent [Internet]. 2014;39(1):47–50.
Available:https://meridian.allenpress.com/jcpd/article-abstract/39/1/47/189335
Geetha RV, Thangavelu L, Others. Evaluation oEvaluation of anti-inflammatory action of Laurus nobilis-an in vitro studyf anti-inflammatory action of Laurus nobilis-An in vitro study. International Journal of Research in Pharmaceutical Sciences [Internet]. 2019; 10(2):1209–13.
Available:https://www.pharmascope.org/index.php/ijrps/article/view/408
Vaishali M, Geetha RV. Antibacterial activity of Orange peel oil on Streptococcus mutans and Enterococcus-An in-vitro study. Research Journal of Pharmacy and Technology [Internet]. 2018;11(2):513–4.
Available:http://www.indianjournals.com/ijor.aspx?target=ijor:rjpt&volume=11&issue=2&article=016
Neville R, Laredo J. Faculty of 1000 evaluation for chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis [Internet]. F1000 - Post-publication peer review of the biomedical literature; 2010.
Available:http://dx.doi.org/10.3410/f.1493957.1198072
Fleischer W, Reimer K. Povidone-iodine in antisepsis--state of the art. Dermatology [Internet]. 1997;195(Suppl.2):3–9.
Available:https://www.karger.com/Article/Abstract/246022
Pollack W, Iny O. Iodine-containing germicidal preparations and method of controlling germicidal activity [Internet]. US Patent. 1990;4946673.
Available:https://patentimages.storage.googleapis.com/4f/ae/3b/15d81e3eee513e/US4946673.pdf
[Cited 2020 Jun 30].
Angel DE, Morey P, Storer J, Mwipatayi BP, Others. The great debate over iodine in wound care continues: A review of the literature. Wound Practice & Research: Journal of the Australian Wound Management Association [Internet]. 2008; 16(1):6.
Available:https://search.informit.com.au/documentSummary;dn=293606395919612;res=IELHEA
Eggers M. Correction to: Infectious disease management and control with povidone iodine. Infect Dis Ther [Internet]. 2019; 8(4):595.
Available: http://dx.doi.org/10.1007/s40121-019-00263-8
Adams D, Quayum M, Worthington T, Lambert P, Elliott T. Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant. J Hosp Infect [Internet]. 2005;61(4):287–90.
Available:http://dx.doi.org/10.1016/j.jhin.2005.05.015
Da Cunha ML, Procianoy RS, Franceschini DT, De Oliveira LL, Cunha ML. Effect of the first bath with chlorhexidine on skin colonization with Staphylococcus aureus in normal healthy term newborns. Scand J Infect Dis [Internet]. 2008;40(8):615–20.
Available:http://dx.doi.org/10.1080/00365540801932447
Ison S, Beattie M. Disinfection, sterilization and preservation (5th Ed) [Internet]. Australian Infection Control. 2002;7:74.
Available:http://dx.doi.org/10.1071/hi02074
Hiom SJ, Furr JR, Russell AD, Dickinson JR. Effects of chlorhexidine diacetate on Candida albicans, C. glabrata and Saccharomyces cerevisiae. J Appl Bacteriol [Internet]. 1992;72(4):335–40.
Available:http://dx.doi.org/10.1111/j.1365-2672.1992.tb01844.x
Bhardwaj P, Hans A, Ruikar K, Guan Z, Palmer KL. Reduced chlorhexidine and daptomycin susceptibility in vancomycin-resistant Enterococcus faecium after serial chlorhexidine exposure [Internet]. Antimicrobial Agents and Chemotherapy. 2017;62.
Available:http://dx.doi.org/10.1128/aac.01235-17
Shaker LA, Dancer BN, Russell AD, Furr JR. Emergence and development of chlorhexidine resistance during sporulation of Bacillus subtilis 168. FEMS Microbiol Lett [Internet]. 1988;51(1):3–6.
Available:https://academic.oup.com/femsle/article-abstract/51/1/73/490006
[Cited 2020 Jun 30].
Shaker LA, Russell AD, Furr JR. Aspects of the action of chlorhexidine on bacterial spores. Int J Pharm [Internet]. 1986;34(1): 51–6.
Available:http://www.sciencedirect.com/science/article/pii/0378517386900098
Kaye KS. Infection Prevention and Control in the Hospital, An Issue of Infectious Disease Clinics - E-Book [Internet]. Elsevier Health Sciences; 2011;312.
Available:https://play.google.com/store/books/details?id=XeXHDDeR84sC
Hadaway LC. Skin flora and infection. J Infus Nurs [Internet]. 2003;26(1):44–8.
Available:http://dx.doi.org/10.1097/00129804-200301000-00006
Chung K-T, Rice SL, Wilson PW, Nelson PE. Sporicidal activity of hydrogen peroxide and iodophor on the spores of Clostridium sporogenes. J Food Sci [Internet]. 1979;44(4):1261–2.
Available:http://doi.wiley.com/10.1111/j.1365-2621.1979.tb03497.x
Program of Randomized Trials to Evaluate Pre-operative Antiseptic Skin Solutions in Orthopaedic Trauma (PREP-IT) Investigators, Slobogean GP, Sprague S, Wells J, Bhandari M, Rojas A, et al. effectiveness of iodophor vs chlorhexidine solutions for surgical site infections and unplanned reoperations for patients who underwent fracture repair: The PREP-IT Master Protocol. JAMA Netw Open [Internet]. 2020;3(4):e202215.
Available:http://dx.doi.org/10.1001/jamanetworkopen.2020.2215
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