INFECTION PREVENTION
drapes are one of the most underused tools across the surgical pathway today,” said Kat Topley. Clinicians using the drapes include Frank McDermot, head of neurosurgery at Edinburgh Eastern General Hospital. Commenting on the drapes he said: “Ioban is a part of the gold standard of care that we provide to all of our patients. It is quick, easy and efficient to use.”
Creating a sterile field
Phillip Roberts, consultant orthopaedic surgeon at University Hospital of North Staffordshire, believes that it is never possible to fully sterilise the skin. “It is, however, possible to clean the skin and then create a sterile field by using an anti-microbial impregnated incise drape, where nothing can regrow. The site is then sealed under plastic in a sterile environment,” he said. “Patients are always advised to wash before they are admitted for elective surgery,” continued Kat Topley. “However, they are rarely asked to confirm that they have done this and, in any case, flora and organisms will start to regrow very quickly after a bath or shower using standard soap products.” NICE recommends that within 24 hours of knife to skin the patient should have a wash to keep the level of organisms to a minimum. Kat Topley says that this advice should be undertaken as a matter of course, as part of standard pre-operative surgical skin preparation. As part of her presentation at the AfPP
While surgical skin preparations do help reduce microbes on the skin surface, bacteria in the deeper skin layers will remain.
event, Kat Topley presented further evidence to demonstrate the benefits of antimicrobial incise drapes. Reporting on the use of plastic iodophor drapes during liver surgery in the World Journal of Surgery in 2003, for example, Yoshimura et al6
found that the SSI
rates of patients treated with an iodophor skin prep alone was 12.1%. In contrast the SSI rate of patients who were treated with iodophor skin prep
and an ioban incise drape was 3.1%. The aim of the study was to investigate the risk factors associated with wound infection during high risk surgery, with special reference to the use of 3M ioban 2 antimicrobial incise drapes. The authors concluded that the non-use of ioban is a possible risk factor for wound infection after liver surgery. More recently, Bejko et al7
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WWW.CLINICALSERVICESJOURNAL.COM I 45
Flexible Endoscope Repairs
Rigid Endoscope Repairs
compared the
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