투관침 부위에 적용하는 포비돈 아이오딘과 클로르헥시딘-에탄올의 소독제 효과 연구
Clinical Study Comparing the Skin Antiseptics of Povidone-iodine and Chlorhexidine-ethanol on Port Site
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
본 연구의 목적은 투관침 부위를 중심으로 복강경하 담낭절제술에 적용하는 소독제인 포비돈 아이오딘과 클로르헥시딘-에탄올에 따른 소독효과의 차이를 비교하기 위한 비동등성 대조군 사전사후설계 실험연구이다. 연구대상자는 서울 소재 1개의 대학병원 외과에 입원한 46명의 환자를 대상으로 난수표를 이용하여 무작위 할당하였으며, 균의 배양과 동정, 균 수(CFU/ml) 측정, 수술부위감염 발생 유무를 통해 소독제 효과의 차이를 비교하였다. 연구결과, 포비돈 아이오딘과 클로르헥시딘-에탄올은 소독 3분 후와 투관침 제거 전의 균 발생률, 균수 변화의 차이와 수술부위감염 발생률은 통계적으로 유의한 차이가 없어 소독효과에 대한 차이는 없는 것으로 나타났다. 따라서, 적절한 소독제 선택 시 소독효과 뿐만 아니라 비용적 측면과 사용의 편의성 등을 고려하는 것이 필요하다. 본 연구는 소독제의 효능과 사용방법에 대한 기초자료 및 교육 자료로 활용될 수 있으며, 소독제에 대한 이해를 높이는데 의의가 있다.
Abstract
The purpose of this study was to compare in antiseptic effect between povidone-iodine and chlorhexidine-ethanol for laparoscopic cholecystectomy on the port site. A total of 46 patients admitted to surgery at one university hospital in Seoul were included in the study. A study group was randomly assigned using a random number table. The antiseptic effect was evaluated and compared to povidone-iodine and chlorhexidine-ethanol by using a culture and identification of bacteria, measurement of the number of bacteria (CFU/ml) and incidence of surgical site infection. Our results show that povidone-iodine and chlorhexidine-ethanol have no statistically significant difference in the incidence rate of bacteria after 3 minutes of disinfection and before removal of the trocar and in the number of bacteria and the incidence of surgical site infection. Thus, in order to select an efficient and appropriate skin antiseptics, we suggest that it is necessary to consider not only the disinfectant effect but also cost and convenience. In this research, our results about effect and usage of skin antiseptics can be used as basic data and educational resource, and this is expected to improve comprehension of skin antiseptics.
참고문헌 (17)
- C. H. Davis, "Trends in laparoscopic colorectal surgery over time from 2005-2014 using the NSQIP database", Journal of Surgical Research, 223, pp.16~21 (2018)[DOI]
- A. P. Legorreta, "Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy", JAMA, 270(12), pp.1429~1432 (1993)[DOI]
- S. Karthik, "Analysis of laparoscopic port site complications : A descriptive study", Journal of minimal access surgery, 9(2), pp.59~ (2013)[DOI]
- C. Richards, "Does using a laparoscopic approach to cholecystectomy decrease the risk of surgical site infection?", Annals of surgery, 237(3), pp.358~ (2003)[DOI]
- M. K. Al-Naser, "Port Site Infections after laparoscopic cholecystectomy", International Journal of Medical Research & Health Sciences, 6(6), pp.132~137 (2017)
- L. M. Napolitano, "Decolonization of the skin of the patient and surgeon", Surgical Infections, 7(Supplement 3), pp.s~3 (2006)[DOI]
- S. J. Choi, "Evaluation of In Vitro Bactericidal Activity of Disinfectants against Major Nosocomial Pathogens", Korean Journal of Nosocomial Infection Control, 5(2), pp.89~98 (2000)
- 최정실, "병원 간호사의 주요 피부소독제 인지도와 수행도에 영향을 미치는 요인 -알코올, 클로르헥시딘, 베타딘을 중심으로-", Journal of Korean Biological Nursing Science, 13(2), pp.125~133 (2011), 한국기초간호학회
- E. Spaziani, "Pre-operative skin antisepsis with chlorhexidine gluconate and povidone-iodine to prevent port-site infection in laparoscopic cholecystectomy : a prospective study", Surgical Infections, 19(3), pp.334~338 (2018)[DOI]
- J. C. Dumville, "Preoperative skin antiseptics for preventing surgical wound infections after clean surgery", Cochrane Database of Systematic Reviews, (3) (2013)[DOI]
- H. Laufman, "Current use of skin and wound cleansers and antiseptics", The American journal of surgery, 157(3), pp.359~365 (1989)
- J. Zinn, "Intraoperative patient skin prep agents : is there a difference?", AORN Journal, 92(6), pp.662~674 (2010)[DOI]
- R. O. Darouiche, "Chlorhexidine–alcohol versus povidone–iodine for surgical-site antisepsis", New England Journal of Medicine, 362(1), pp.18~26 (2010)[DOI]
- T. Kunisada, "Investigation on the efficacy of povidone-iodine against antiseptic-resistant species", Dermatology, 195(Suppl. 2), pp.14~18 (1997)
- T. Yasuda, "Comparison of bactericidal effects of commonly used antiseptics against pathogens causing nosocomial infections", Dermatology, 195(Suppl. 2), pp.19~28 (1997)
- A. P. Kulkarni, "A prospective randomised trial to compare the efficacy of povidone-iodine 10% and chlorhexidine 2% for skin disinfection", Indian Journal of Anaesthesia, 57(3), pp.270~ (2013)[DOI]
- A. Noorani, "Systematic review and meta‐analysis of preoperative antisepsis with chlorhexidine versus povidone–iodine in clean‐contaminated surgery", British Journal of Surgery, 97(11), pp.1614~1620 (2010)[DOI]