Alcohol-based antisepsis without the use of chlorhexidine for arthroscopy in horses.

The research article is about a study conducted to determine the effectiveness of using alcohol-based antisepsis, specifically 70% isopropyl alcohol, against using chlorhexidine gluconate for reducing bacterial counts on horse skin during arthroscopic surgery. The results showed that alcohol-based antisepsis was just as effective as chlorhexidine, indicating a possible alternative antisepsis method.

Objective of Study and Methodology

• The goal of the research was to investigate the immediate and post-surgical reduction in bacterial count, measured in colony-forming units per milliliter (CFU/mL), on equine skin prepared with two different antiseptic methods—chlorhexidine gluconate-based and isopropyl alcohol-based—in the context of clinical arthroscopic surgery.
• The researchers hypothesized that the reduction in bacterial count would not significantly deviate between the two methods, both immediately after skin preparation and at the end of the surgery.
• For the execution of the study, six horses underwent 40-minute bilateral tarsocrural joint arthroscopy, a surgical procedure on the joint located between the tibia and the fibula. Each horse’s limb was randomly assigned to one of two groups.
• Group A limbs were prepared with a rough scrubbing using 4% chlorhexidine gluconate and then a sterile scrub using 2% chlorhexidine gluconate. Group B, on the other hand, experienced a neutral soap rough scrub followed by a 90-second sterile scrub with 70% isopropyl alcohol.
• Samples were taken before the rough scrub (T0), immediately following the sterile scrub (T1), and at the end of the surgery (T2) to gauge the effectiveness of the antiseptic methods.

Results

• The results showed no significant difference in immediate and sustained bacterial reduction between the two treatment groups (p=0.46, p=0.42), suggesting that both chlorhexidine and alcohol-based antisepsis are equally effective in control of bacterial contamination during surgery.
• Both the chlorhexidine and the alcohol-based group experienced at least a 2-log reduction in bacterial count immediately after the surgery, and the reduction was sustained.
• The researchers noted certain limitations to their study, including the small population size, short surgical duration, lack of extensive follow-up, and the fact that the researchers were not blinded to treatment during sample collection.

Conclusions

• This study provided evidence that isopropyl alcohol-based antisepsis could be as effective as chlorhexidine in reducing bacterial counts on equine skin during surgery without the need for chlorhexidine.
• This discovery supports further investigation and potential implementation of alcohol-based antisepsis in clinical surgery as a method of preparing the surgical site.