Skin Disinfection Agents

iStock_000073325415_MediumOkay, so I admit it.  Sometimes Rick picks something for PodMed I shake my head about, and this study, published in NEJM, was one of them.  What's the broad applicability of the choice of topical agents to disinfect the skin previous to an incision in women about to undergo C-section? Here's what's great about my job: I continuously have the opportunity to become educated, and this is a stellar example.  Turns out that choosing a chlorhexidine-based agent rather than an iodine-based one results in about half the number of skin infections in women who have this operation.  And since the average cost of treating such an infection is about $3500, that's a significant savings, let alone avoiding interruption in care to the infant and morbidity for the mom.

This single site study randomized over 1100 women to use of chlorhexidine or iodine based solutions for skin swabbing prior to Cesarean section.  Nationally this population alone is significant; C-section is the most common surgical procedure among US women, with more than 1.3 million taking place in 2013. Reducing infections is obviously a great outcome, and Rick and I agree that as results of this study are promulgated, use of chlorhexidine-based scrubs will no doubt be employed in many other procedures.

Other topics this week include relaxing surgical resident work hours, also in NEJM, and update on Zika virus, and questionable trial results for rivaroxaban in the BMJ.  Until next week, y'all live well.


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