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  • Title: Significant reduction in incidence of wound contamination by skin flora through use of microbial sealant.
    Author: Towfigh S, Cheadle WG, Lowry SF, Malangoni MA, Wilson SE.
    Journal: Arch Surg; 2008 Sep; 143(9):885-91; discussion 891. PubMed ID: 18794427.
    Abstract:
    HYPOTHESIS: Application of skin sealant prior to incision reduces microbial contamination of the wound. DESIGN: Prospective, randomized, multicenter clinical trial. SETTING: Six teaching hospitals. PATIENTS: A total of 177 adult patients undergoing elective open inguinal hernia repair were randomized to either standard skin preparation with 10% povidone-iodine or skin preparation followed by cyanoacrylate-based liquid microbial sealant. INTERVENTIONS: Wound contamination was assessed during surgery by microbial sampling inside the wound at initiation of skin incision and prior to skin closure. MAIN OUTCOME MEASURES: The primary outcome measures were the safety and effectiveness of cyanoacrylate-based microbial sealant to reduce bacterial contamination during surgery. The secondary outcome measure was reduction of postoperative surgical site infections using microbial sealant. RESULTS: Demographics were similar. Patients treated with sealant were more likely to have no bacterial cells found in the wound than control participants (47% vs 31%; P = .04). Three patients developed surgical site infections; all were in the control group (P = .25). Independent factors that reduced wound contamination were use of microbial sealant (odds ratio, 0.45; confidence interval, 0.23-0.88; P = .02) and perioperative antibiotics (odds ratio, 0.24; confidence interval, 0.10-0.58; P = .001). CONCLUSION: Cyanoacrylate-based microbial sealant may be an important tool to reduce wound contamination and potentially prevent surgical site infections.
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