Vendela M Scheer1, Malin Bergman Jungeström2, Maria Lerm3, Lena Serrander4, Anders Kalén5. 1. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Electronic address: vendela.scheer@liu.se. 2. Division of Clinical Microbiology, Faculty of Health Sciences, University Hospital, Linköping, Sweden. 3. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 4. Division of Clinical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 5. Division of Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Abstract
BACKGROUND: Propionibacterium acnes is a common cause of infection following shoulder surgery. Studies have shown that standard surgical preparation does not eradicate P acnes. The purpose of this study was to examine whether topical application of benzoyl peroxide (BPO) gel could decrease the presence of P acnes compared with today's standard treatment with chlorhexidine soap (CHS). We also investigated and compared the recolonization of the skin after surgical preparation and draping between the BPO- and CHS-treated groups. METHODS: In this single-blinded nonsurgical study, 40 volunteers-24 men and 16 women-were randomized to preoperative topical treatment at home with either 5% BPO or 4% CHS on the left shoulder at the area of a deltopectoral approach. Four skin swabs from the area were taken in a standardized manner at different times: before and after topical treatment, after surgical skin preparation and sterile draping, and 120 minutes after draping. RESULTS: Topical treatment with BPO significantly reduced the presence of P acnes measured as the number of colony-forming units on the skin after surgical preparation. P acnes was found in 1 of 20 subjects in the BPO group and 7 of 20 in the CHS group (P = .044). The results remained after 2 hours (P = .048). CONCLUSION: Topical preparation with BPO before shoulder surgery may be effective in reducing P acnes on the skin and preventing recolonization.
RCT Entities:
BACKGROUND:Propionibacterium acnes is a common cause of infection following shoulder surgery. Studies have shown that standard surgical preparation does not eradicate P acnes. The purpose of this study was to examine whether topical application of benzoyl peroxide (BPO) gel could decrease the presence of P acnes compared with today's standard treatment with chlorhexidine soap (CHS). We also investigated and compared the recolonization of the skin after surgical preparation and draping between the BPO- and CHS-treated groups. METHODS: In this single-blinded nonsurgical study, 40 volunteers-24 men and 16 women-were randomized to preoperative topical treatment at home with either 5% BPO or 4% CHS on the left shoulder at the area of a deltopectoral approach. Four skin swabs from the area were taken in a standardized manner at different times: before and after topical treatment, after surgical skin preparation and sterile draping, and 120 minutes after draping. RESULTS: Topical treatment with BPO significantly reduced the presence of P acnes measured as the number of colony-forming units on the skin after surgical preparation. P acnes was found in 1 of 20 subjects in the BPO group and 7 of 20 in the CHS group (P = .044). The results remained after 2 hours (P = .048). CONCLUSION: Topical preparation with BPO before shoulder surgery may be effective in reducing P acnes on the skin and preventing recolonization.
Authors: Stephen G Thon; Adam J Seidl; Jonathan T Bravman; Eric C McCarty; Felix H Savoie; Rachel M Frank Journal: Curr Rev Musculoskelet Med Date: 2020-02
Authors: Steven M Maurer; Laura Kursawe; Stefan Rahm; Julia Prinz; Annelies S Zinkernagel; Annette Moter; Stefan P Kuster; Reinhard Zbinden; Patrick O Zingg; Yvonne Achermann Journal: Antimicrob Resist Infect Control Date: 2021-02-01 Impact factor: 4.887