Can Chlorhexidine Gluconate Reduce Postoperative Surgical Site Infection

Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
Postoperative surgical site infection (SSI) remains a common healthcare-associated infection many patients have to deal with following a surgical procedure. Eiselt (2009) claims that approximately 355,500 surgical patients develop SSIs following orthopedic surgery every year. The number can go as high as 1,000 SSIs every day. In a case-control study of 1,260 patients undergoing hip replacement surgery, approximately 2 percent developed SSI (Eiselt, 2009). Additionally, SSI is complicated by evidence of multi-resistant organisms such as Staphylococcus aureus (S. aureus). About 50 percent of SSIs occurring following hip replacement are caused by S. aureus (Eiselt, 2009). The statistics indicate that stringent measures need to be taken to prevent SSIs. One solution is the elimination of identifiable risks such as optimal cleaning and cleansing of the equipment and environment of the surgical site. The National Quality Forum recommends the use of chlorhexidine gluconate or iodine combined with alcohol in the preparation and cleaning of the surgical site (Greene, 2012). However, the use of chlorhexidine gluconate is controversial. Some studies show that it can reduce surgical site infection, while others indicate otherwise. The capstone project will focus on evaluating whether chlorhexidine gluconate can reduce post-surgical site infection among orthopedic patients.
PICOT Question:
PICOT: For orthopedic patients (P), does preadmission cleansing with chlorhexidine gluconate (I), compared to usual care (c), reduce the risk of post-surgical site infection (O) after the procedure (t)?
Criteria

Article 1

Article 2

Article 3

APA-Formatted Article Citation with Permalink

Eiselt, D. (2009). Presurgical skin preparation with a novel 2% chlorhexidine gluconate cloth reduces rates of surgical site infection in orthopaedic surgical patients. Orthopaedic Nursing, 28(3), 141-145. sci-hub.st/10.1097/nor.0b013e3181a469db

Obamuyide, H. A., Omololu, A. B., Oluwatosin, O. M., Ifesanya, A. O., & Fasina, A. N. O. (2015). Comparison of Chlorhexidine-Alcohol and Povidone Iodine Skin Preparation Skin Preparation Solutions in Orthopaedic and Trauma Surgery at An African Tertiary Hospital. East & Central African Journal of Surgery, 20(2), 80–87. http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=111494200&site=ehost-live

Makhni, M. C., Jegede, K., Lombardi, J., Whittier, S., Gorroochurn, P., Lehman, R. A., & Riew, K. D. (2018). No clear benefit of chlorhexidine use at home before surgical preparation. The Journal of the American Academy of Orthopaedic Surgeons, 26(2), e39. /pmc/articles/PMC5768234/

How Does the Article Relate to the PICOT Question?

The article argues to the PICOT by arguing in support of chlorhexidine gluconate in reducing post-surgical site infection

The study examines the effectiveness of chlorhexidine-alcohol in comparison to Povidone Iodine

The article relates to the PICIT question because it examines whether chlorhexidine is useful before surgical preparation

Quantitative, Qualitative (How do you know?)

Quantitative. The researcher uses a comparison between two variables

Quantitative because it examines a relationship between two variables, chlorhexidine and Povidone

Quantitative because it uses statistical methods in data analysis

Purpose Statement

The aim of the study is to determine if the use of 2% chlorhexidine gluconate (CHG) cloth without rinsing can reduce the SSI rate among general surgery patients.

The purpose of the study is to evaluate the type of bacteria flora on the skin of orthopedic patients while also assessing the effectiveness of Povidone-Iodine and Chlorhexidine-Alcohol (CHG-A) preadmission application on the skin.

The aim of the study is to evaluate the effectiveness of chlorhexidine gluconate in decreasing bacteria counts.

Research Question

Does 2% CHG no-rinse in place of provide-iodine (Betadine) reduce SSI rate

Is Povidone-Iodine more effective than Chlorhexidine-Alcohol in reducing post-surgical infection?

Does the use of chlorhexidine gluconate eliminate the risk of bacterial infection before spine surgery?

Outcome

The rate of SSI was reduced by half after application of 2% CHG no-rinse cloths in place of Betadine skin antiseptic among orthopedic patients complete joint surgical procedures.

The SSI reduced from 60% to 22% for Povidone-Iodine compared to 49%-6.2% after application of Chlorhexidine-Alcohol

After the use of chlorhexidine gluconate wipes on the neck preoperative, bacteria count decreased, but the results were not statistically significant

Setting
(Where did the study take place?)

Lakeview Hospital, a 97-bed community acute care hospital located om Stillwater, Minnesota.

An orthopedics and trauma unit in a teaching hospital located in Africa

Participants seeking operative surgery at a healthcare facility

Sample

727 patients u...