Hesamodin Askari Majdabadi , Mohsen Soleimani , Majid Mirmohammadkhani , Elham Zamanipoor,
Volume 78, Issue 11 (2-2021)
Abstract
Background: Infection is a vital problem in intensive care units. Currently, chlorhexidine solution is used to reduce oral colonization. This study aimed to determine the efficacy of chlorhexidine solution on oropharyngeal bacterial colonization in hospitalized patients in the intensive care units.
Methods: This descriptive study (from August 2018 to May 2019) was performed on 60 patients who administered in medical and surgical intensive care units (ICUs) in one of the university hospitals in Semnan city. Patients admitted to (ICUs) were selected according to inclusion criteria. At the time of admission to the intensive care unit, oropharyngeal colonization of patients was assessed. Forty-eight hours after admission and using the chlorhexidine solution 0.2% three times a day, oropharyngeal colonization was assessed again. Data analysis was performed with SPSS software, version. 22 in the significant level of 0.05.
|
Results: This study showed most of the patients in this study were male (80%) with mean age of 45.23±15.19 years. Most patients were transferred from the emergency department to intensive care units and had endotracheal tubes. At the time of admission to the intensive care unit, 8 patients were infected with E. coli and 6 patients were infected with Klebsiella. The results also showed that the use of chlorhexidine 0.2% had no significant effect on the reduction of micro-organisms in the oropharyngeal area. Forty-eight hours after admission to ICUs, the incidence of E. coli infection increased (P=0.01) but there was no significant increase in the klebsiella infection rate (P=0.25).
Conclusion: This study showed that the use of chlorhexidine solution 0.2% did not affect the reduction of micro-organisms in the oropharyngeal areas of patients. Therefore, oral care protocols that include mechanical movements and toothbrushing should be considered to reduce the occurrence of micro-organisms. This study also found that most patients who were referred to the intensive care unit were contaminated with pathogenic micro-organisms. Therefore, consideration should be given to appropriate strategies to reduce infections in the emergency department.
|
Ramyar Rahimi Darehbagh , Ebrahim Khajeh, Daem Roshani , Farhang Safarnejhad,
Volume 82, Issue 12 (3-2025)
Abstract
Background: Surgical site infections (SSIs) represent one of the most common and significant complications following surgical interventions. These infections not only prolong hospital stay and recovery but also impose a considerable economic burden on healthcare systems and patients. Reducing the risk of SSIs is therefore a major focus of perioperative care, and several strategies have been proposed to minimize their occurrence. One of the most widely practiced preventive measures is preoperative skin antisepsis, aimed at lowering the microbial load at the surgical site. Among available antiseptics, chlorhexidine has been shown to have broad-spectrum antimicrobial activity and sustained effectiveness. This study was designed to evaluate the effect of preoperative chlorhexidine showers on the incidence of SSIs in patients undergoing elective inguinal hernia surgery.
Methods: A randomized clinical trial was carried out in 2019 at Kowsar Hospital, Sanandaj. A total of 300 patients scheduled for elective inguinal hernia repair were enrolled and randomly assigned into three groups of 100 participants each. The intervention group was instructed to take a shower with 4% chlorhexidine solution on the night before surgery. Control group 1 took a routine bath using regular detergents, while control group 2 did not bathe prior to the operation. All patients were monitored for the occurrence of superficial SSIs for up to 30 days postoperatively.
Results: Among the 300 patients included in the study, 12 cases (4%) of superficial SSIs were documented. The distribution of infections varied significantly across the groups: one case in the chlorhexidine group, three cases in the regular detergent group, and eight cases in the group that did not shower. Statistical analysis confirmed that the difference in infection rates among the groups was significant (P=0.034).
Conclusion: The findings of this clinical trial demonstrate that preoperative showers with 4% chlorhexidine solution are effective in reducing the incidence of SSIs in patients undergoing elective inguinal hernia surgery. Implementing this simple, low-cost intervention may therefore be a valuable strategy in routine surgical practice to enhance patient outcomes and reduce postoperative complications.
