Vet Comp Orthop Traumatol 1988; 01(03/04): 122-129
DOI: 10.1055/s-0038-1633177
Short Communication
Schattauer GmbH

Chlorhexidine Wound Lavage and Suture Soaking for Prevention of Suture-Related Infections

K. Wendelburg*
1   From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 1935 Coffey Road, Columbus, Ohio
,
D. D. Smeak
1   From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 1935 Coffey Road, Columbus, Ohio
,
J.J. Kowalski
1   From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 1935 Coffey Road, Columbus, Ohio
› Author Affiliations
Funded by Canine Research Fund #611214. Surgery performed in the Straumann Laboratory for Surgical Research.
Further Information

Publication History

Publication Date:
23 February 2018 (online)

The effectiveness of chlorhexidine in preventing suture-related infections in two groups of dogs at high and low levels of bacterial contamination was examined. Prior to placing the sutures, the lateral stifle incisions were inoculated with Staphylococcus aureus and lavaged with either a 1 % chlorhexidine solution (treated groups) or sterile normal saline (control groups). Chlorhexidine significantly reduced the initial bacterial numbers and clinical inflammatory response in wounds contaminated with high or low numbers of bacteria. Chlorhexidine significantly decreased the tissue inflammation associated with the polyester sutures when contaminated with high concentrations of bacteria.

* Dr. Wendelburg’s current address is West Los Angeles Veterinary Medical Group, 1818 South Sepulveda Blvd., Los Angeles, California 90025.


 
  • References

  • 1 Cruse P J, Ford R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980; 60: 27-40.
  • 2 Galland R B, Heine K J, Trachtenberg L S, Hiram C P. Reduction of surgical wound infection rates in contaminated wounds treated with antiseptic combined with systemic antibiotics: An experimental study. Surgery 1982; 91: 329-32.
  • 3 Robson M L, Kirzek T J, Heggers J P. Biology of surgical infections. Current Problems in Surgery. Yearbook Medical Publishers, Inc.; Chicago: March 1973
  • 4 Meares Jr E M. Factors that influence surgical wound infections. Role of prophylactic antibiotic therapy. Urology 1975; VI (05) 535-46.
  • 5 Blomstedt B, Oesterberg B, Bergstrand A. Suture material and bacterial transport. Acta Chir Scand 1977; 143: 71-3.
  • 6 McGeehan D, Hunt D, Chaudhur A, Rutter P. An experimental relationship between synergistic wound sepsis and suture materials. Br J Surg 1980; 67: 636-9.
  • 7 Everett W G. Suture materials in general surgery. Prog Surg 1970; 8: 14-37.
  • 8 James R C, Macleod C M. Induction of staphylococcal infections in mice with small inocula introduced on sutures. Br J Exp Pathol 1961; 42: 266-77.
  • 9 Elek S D, Conen P E. The virulence of Staphylococcus pyogenes for man. Br J Exper Path 1957; 38: 573-86.
  • 10 Elek S D. Experimental staphylococcal infections in the skin of man. Ann NY Acad Sci 1956; 65: 85-9.
  • 11 Blomstedt G C. Infections in neurosurgery: A randomized comparison between silk and polyglycolic acid. Acta Neurol 1985; 76: 90-3.
  • 12 Sharp W V, Belden T A, King P H, Teague D C. Suture resistance to infection. Surgery 1982; 91: 61-3.
  • 13 Scher K S, Bernstein J M, Jones C W. Infectivity of vascular sutures. Am Surgeon 1985; 51: 577-9.
  • 14 Blomstedt B, Osterberg B. Suture materials and wound infections. Acta Chir Scand 1978; 144: 269-74.
  • 15 Oesterberg B, Blomstedt B. Effect of suture material on bacterial survival in infected wounds. Acta Chir Scand 1979; 145: 431-4.
  • 16 Katz S, Izhar M, Mirelman D. Bacterial adherence to surgical sutures – a possible factor in suture-induced infection. Ann Surg 1981; 194: 35-41.
  • 17 Dulisch M L. Suture reaction following extra-articular stifle stabilization in the dog. Part I: A retrospective study of 161 stifles. J Am Anim Hosp Assoc 1981; 17: 569-71.
  • 18 Dulisch M L. Suture reaction following extra-articular stifle stabilization in the dog. Part II: A prospective study of 66 stifles. J Am Anim Hosp Assoc 1981; 17: 572-4.
  • 19 DiGiglio J W D, Leonard G L, Ochsner J L. Local irrigation with an antibiotic solution in the prevention of infection in vascular prosthesis. Surgery 1970; 67: 836-9.
  • 20 Richardson Jr R L, Pate J W, Wolf R Y. et al. The outcome of antibiotic-soaked arterial grafts in guinea pig wounds contaminated with E. coli or Staph, aureus. J Thoracic Cardiovasc Surg 1970; 59: 635-8.
  • 21 Lord J W, Rossi G, Daliana M. Intraoperative antibiotic wound lavage: An attempt to eliminate postoperative infection in arterial and clean general surgical procedures. Ann Surg 1977; 185: 634-8.
  • 22 DeAngelis M, Lau R E. A lateral retinacular imbrication technique for the surgical correction of anterior cruciate ligament rupture in the dog. J Am Vet Med Assoc 1970; 157: 79-83.
  • 23 Aron D N, Purinton P T. Replacement of the collateral ligaments of the canine tarsocrural joint: A proposed technique. Vet Surg 1985; 14: 178-84.
  • 24 Flo G L. Modification of the lateral retinacular imbrication technique for stabilizing cruciate ligament injuries. J Am Anim Hosp Assoc 1975; 11: 570-6.
  • 25 Gambardella P C, Wallace L J, Cassidy F. Lateral suture technique for management of anterior cruciate ligament rupture in dogs: A retrospective study. J Am Anim Hosp Assoc 1981; 17: 33-8.
  • 26 Rodeheaver G, Edgerton M T, Smith S. et al. Antimicrobial prophylaxis of contaminated tissues containing suture implants. Am J Surg 1977; 133: 609-11.
  • 27 Amber E I, Henderson R A, Swaim S F, Gray B W. A comparison of antimicrobial efficacy and tissue reaction of four antiseptics on canine wounds. Vet Surg 1983; 12: 63-8.
  • 28 Sindelar W F, Mason G R. Efficacy of povidone-iodine irrigation in prevention of surgical wound infections. Surgical Forum 1977; 28: 48-51.
  • 29 Sherlock D J, Ward A, Holl-Allen R T J. Combined preoperative antibiotic therapy and intraoperative topical povidone-iodine. Arch Surg 1984; 119: 909-11.
  • 30 Gray J G, Lee J R. The effect of topical povidone-iodine on wound infection following abdominal surgery. Br J Surg 1981; 68: 310-3.
  • 31 Sindelar W F, Mason G R. Irrigation of subcutaneous tissue with povidone-iodine solution for prevention of surgical wound infections. Surg Gyn Obst 1979; 148: 227-31.
  • 32 Barr L L. Prevention of wound infection by 2-minute lavage with Betadine solution. J Am Osteopath Assoc 1978; 77: 442-4.
  • 33 Viljanto J. Disinfection of surgical wounds without inhibition of normal wound healing. Arch Surg 1980; 115: 253-6.
  • 34 Paul J W, Gordon M A. Efficacy of a chlorhexidine surgical scrub compared to that of hexachlorphene and povidoneiodine. Vet Med Small Anim Clin. May 1982: 573-9.
  • 35 Rosenburg A, Alatary S D, Peterson A F. Safety and efficacy of chlorhexidine gluconate. Surg Gyn Obstet 1976; 143: 789.
  • 36 Fowler A W. Effect of chlorhexidine on tissues. Lancet 1963; i: 387-90.
  • 37 Lowbury E J L, Lilly H A. Effect of blood on disinfection of surgeon’s hands. Br J Surg 1974; 61: 19-22.
  • 38 Sapeika N. (ed). Antiseptics. Actions and uses of drugs. Capetown, South Africa: A-A Balkam Publishing Co.; 140 1976
  • 39 Harvey S C. Antimicrobial Drugs. Antiseptics and disinfectants. In: Osol A. (ed). Remington’s pharmaceutical sciences. 16th ed.. Easton, PA: Mack Publishing Co.; 1101 1980
  • 40 Steel R G, Torrie J H. Principles and procedures of statistics–biometrical approach. 2nd ed.. Washington, DC: McGraw-Hill Book Co.; 1980
  • 41 Devore J L. Probability and statistics for engineering and science. Monteray, CA: Brooks/Cole Publishing Company; 1987: 302-4.
  • 42 Haines S J. Topical antibiotic prophylaxis in neurosurgery. Neurosurgery 1982; 11: 250-3.
  • 43 Lindsey D, Nava C, Marti M. Effectiveness of penicillin irrigation in control of infection in sutured lacerations. J Trauma 1982; 22: 186-9.
  • 44 Moylan J A. The proper use of local antimicrobial agents in wounds. World J Surg 1980; 4: 433-7.
  • 45 Taylor T V, Walker W S, Mason R L, Richmond J, Lee D. Preoperative intraparietal (intraincisional) cefoxitin in abdominal surgery. Br J Surg 1982; 6: 461-2.
  • 46 Armstrong C P, Taylor T V, Reeves D S. Pre-incisional intraparietal injection of cephamandole: A new approach to wound infection prophylaxis. Br J Surg 1982; 69: 459-60.
  • 47 Scher K S. Prevention of wound infection: The comparative effectiveness of topical and systemic cefazolin and povidone-iodine. Am Surgeon 1982; 48: 268-70.
  • 48 Pitt H A, Postier R G, Gadacz T R, Cameron J R L. The role of topical antibiotics in “high risk” biliary surgery. Surgery 1982; 91: 518-24.
  • 49 Benjamin J B, Volz R G. Efficacy of a topical antibiotic irrigant in decreasing or eliminating bacterial contamination in surgical wounds. Clin Orthop Rel Res 1984; 184: 114-7.
  • 50 Sood S. Role of intraoperative wound lavage in postoperative wound infection. Ind J Med Res 1985; 81: 92-5.
  • 51 Lord J W. Intraoperative antibiotic wound irrigation. Surg Gyn Obst 1983; 157: 357-61.
  • 52 Bergamini T M, Lamont P M, Cheadle W G, Polk H C. Combined topical and systemic antibiotic prophylaxis in experimental wound infection. Am J Surg 1984; 147: 753-6.
  • 53 Bertone A L, McIlwraith C W. et al. Effect of four antimicrobial lavage solutions on the tarsocrural joint of horses. Vet Surg 1986; 15: 305-15.
  • 54 Stevenson S, Olmstead M L, Kowalski J. Bacterial culturing for prediction of postoperative complications following open fracture repair in small animals. Vet Surg 1986; 15: 99-102.