By G. K. Richards, J. J. Prentis, I. Wink (auth.), Hans K. Uhthoff MD, FRCS(C), Elvira Stahl BA, FAAAS, FAMWA (eds.)
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Extra resources for Current Concepts of Infections in Orthopedic Surgery
37 6. : Airborne contamination of wounds in joint replacement operations: the relationship to sepsis rates. J. Hosp. Infect. i, 111, 1983b. 7. : Infection after total hip replacement. J. Bone Joint Surg. 65B, 412, 1983. Specific Measures to Reduce Operating Room Infections R. M. LETTS Surgical Wound contamination The primary sources of surgical wound contamination are a) contact, b) endogenous, and c) airborne. The introduction of microorganisms directly into the wound by contact with instruments, surgeons, and operating room personnel can be reduced by good barrier systems encompassing both surgeon and patient.
Combined with ethyl or isopropyl alcohol, it appears to be the most effective skin antiseptic for surgeons' hands and for patients' skin. Soap Soap is not an antiseptic and possesses no bactericidal properties in its own right. For many years it formed the basis for the surgical scrub, contributing mainly as a simple cleansing agent but also being capable by this action of removing a large part of the contaminating microbes which form the so-called transient flora. It has no action, however, on the resident skin flora.
A further development of this work (Lowbury et al, 1974) demonstrated not only the synergistic action of both ethyl and isopropyl alcohols with chlorhexidine but also showed that their antimicrobial action continued for at least three hours provided the hand was covered with a rubber surgical glove (Table III). They also showed that the process of washing the hands was not essential to the degerming activity. 5% chlorhexidine in 95% alcohol, each applica- 29 Table II. 3 Table III. 4 Table IV. 2 * Two applications of 5 mL rubbed on the hands and wrists until dry.