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Evaluation of Arthrocentesis Site Bacterial Flora before and after 4 Methods of Preparation in Horses with and without Evidence of Skin Contamination
Author(s) -
Zubrod Chad J.,
Farnsworth Kelly D.,
Oaks J. Lindsay
Publication year - 2004
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2004.04074.x
Subject(s) - iodophor , medicine , contamination , arthrocentesis , skin flora , iodine , veterinary medicine , colony forming unit , surgery , bacteria , biology , ecology , materials science , alternative medicine , genetics , synovial fluid , metallurgy , osteoarthritis , pathology
Objective— To evaluate the effectiveness of four methods of povidone–iodine preparation on skin bacterial flora of arthrocentesis sites, in horses, with and without evidence of skin contamination. Study Design— Prospective randomized study. Animals— Twenty‐four adult horses. Methods— Horses were assigned to either the clean or contaminated group based on housing environment and visual evidence of contamination. Using a moist sterile swab, microbial culture samples were obtained from the skin over the distal interphalangeal joints immediately before and after preparation. Each site was aseptically prepared with 1 of 4 povidone–iodine techniques: 10‐minutes scrub, 5‐minutes scrub, three 30‐second scrubs, or commercial one‐step iodophor surgical solution. Colony forming units (CFUs) were determined for each sample, 24 hours after inoculation, on blood agar plates. Results— Mean (±SD) pre‐scrub CFUs/mL was significantly higher in the contaminated group (9588.33±1223.65) compared with the clean group (4489.00±3842.03) ( P <.01). After preparation of the arthrocentesis sites, there were no significant differences in post‐scrub CFUs/mL among the 10 minutes (mean clean, 46.00±64.36; mean contaminated, 28.67±18.04), 5 minutes (mean clean, 84.17±109.80; mean contaminated, 40.33±44.52), three 30 seconds povidone–iodine scrubs (mean clean, 95.50±172.29; mean contaminated, 46.67±56.94), or application of a commercial one‐step iodophor surgical solution (mean clean, 102.17±161.78; mean contaminated 117.67±143.78); or between the clean (81.96±131.69) and contaminated groups (58.33±85.90) ( P <.01). Conclusions— Preparation of the distal interphalangeal joint arthrocentesis site with each of these techniques significantly reduces the bacterial flora to a similar level for arthrocentesis in horses with and without evidence of skin contamination. Clinical Relevance— Aseptic preparation of the skin over the distal interphalangeal joint may be accomplished with any of these techniques.