Reduced wound contamination of a chlorhexidine gluconate (CHG) containing surgical incise drape using an ex vivo porcine skin incisional model.

Authors:
Isaac Salvatierra, Marnie Peterson, Ranjani Parthasarathy, Shazia Siddiqui

Body of Abstract:
Background: Adhesive drapes, including antimicrobial-impregnated drapes, have been utilized to help decrease the risk of wound contamination during surgery. However, an increase in the risk of wound contamination has been noted when drape adhesion was compromised at the wound edge. This study examined a new investigational CHG Drape for its antimicrobial effectiveness and ability to help reduce wound contamination via the adhesive properties of the drape compared to a non-antimicrobial adhesive drape (Non-AM Drape).
Methods: An ex vivo porcine skin, incisional wound model was developed to assess these properties for up to 6 hours. Skin was inoculated with Methicillin-Resistant Staphylococcus aureus (MRSA), Escherichia coli or Pseudomonas aeruginosa (seeded areas) followed by application of drapes, incision, irrigation, manipulation followed by microbial recovery/assessment of migration.
Results: CHG Drape placement demonstrated a significant reduction in MRSA counts at all time points in the seeded and incision/wound areas when compared to Non-AM Drape placement (p<0.05). MRSA migration was quantified by the mean wound/seeded ratio (log CFU/mL) at 4 hours (CHG Drape 0.13, Non-AM Drape 0.70, n=7, p<0.0001). CHG Drape placement also demonstrated a significant reduction of E. coli and P. aeruginosa in incision/wound areas (p<0.0001); and reduction in the seeded area of E. coli (p<0.0001) and P. aeruginosa (p<0.05) compared to the Non-AM Drape placement. Migration after 4 hours was also mapped by drape blotting on agar plates. CHG Drape demonstrated little to no colonies present in the migration zone for all microorganisms tested. Conclusions: The new investigational CHG incise drape demonstrated broad-spectrum antimicrobial effectiveness and helped reduce microbial migration and wound contamination compared to a non-antimicrobial incise drape. These findings suggest that the CHG Drape’s antimicrobial effectiveness combined with its superior skin adhesive properties, which reduces the risk of drape lift, can potentially be used to reduce risk of wound contamination in surgical procedures.