Antiseptic Use in Wounds of the Lower Limb

The goal of this study is to go over all of the available research on antiseptic safety and efficacy in surgical wounds. Different antiseptic solutions, irrigation amounts, time scales, and delivery systems have been examined in order to develop evidence-based antiseptic recommendations for plastic, orthopaedic, and foot and ankle surgical operations.

Methods: To find in-vitro and in-vivo research relevant to antiseptic use in an orthopaedic context, a literature search was conducted utilising the online databases Medline and EMBase. Antiseptic, irrigation fluid, bacitracin, hydrogen peroxide, povidone-iodine, and chlorhexidine were among the terms used in the search. The whole text of literature published in English from the beginning to July 2020 was evaluated for inclusion. Authors analysed antiseptic efficacy and/or toxic effect of antiseptic on cells present in orthopaedic wounds, so cellular and animal research were included. Antiseptic usage in a surgical context was examined in clinical studies that matched the criteria for inclusion in this review, with a focus on foot and ankle procedures. Case reports, case series, case control, prospective and retrospective investigations, and randomised controlled trials were among them. In-vitro, animal, and human investigations were all classified. In-vitro, animal, and human research were detected in twenty-three, eleven, and forty-seven papers, respectively. These have been summarised and presented in a narrative fashion in this article.

Antiseptic skin treatment before plastic and orthopaedic surgeries minimises the incidence of post-operative infection, according to the findings.

Conclusion: Routine intra-operative prophylactic antiseptic usage should be used with caution because it increases the risk of local and systemic problems. However, there is considerable evidence to support the use of antiseptics when prepping the skin prior to surgery. Because no single agent or solution is effective against all pathogens, determining the ideal antiseptic preparation remains a point of contention. To determine the efficacy of antiseptics in the prevention and treatment of infections, more research is required.

Author (s) Details

Tiffanie-Marie Borg
Academic Plastic and Reconstructive Surgery Group, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kindom.

Fahima A. Begum
University College Hospital, United Kingdom.

Hamed Mazoochy
Royal London Hospital, Barts Health NHS Trust, United Kingdom.

Nima Heidari
Royal London Hospital, Barts Health NHS Trust, United Kingdom.

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