Skin Antisepsis before Surgical Fixation of Extremity Fractures
Skin antisepsis with iodine povacrylex resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in patients with closed limb fractures but not in those with open fractures.
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| Veröffentlicht in: | The New England journal of medicine 2024-02, Vol.390 (5), p.409-420 |
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| container_title | The New England journal of medicine |
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| creator | Sprague, Sheila Slobogean, Gerard Wells, Jeffrey L O'Hara, Nathan N Thabane, Lehana Mullins, C Daniel Harris, Anthony D Wood, Amber Viskontas, Darius Apostle, Kelly L O'Toole, Robert V Joshi, Manjari Johal, Herman Al-Asiri, Jamal Hymes, Robert A Gaski, Greg E Pilson, Holly T Carroll, Eben A Babcock, Sharon Halvorson, Jason J Romeo, Nicholas M Matson, Christopher A Higgins, Thomas F Marchand, Lucas S Bergin, Patrick F Morellato, John Van Demark, 3rd, Robert E Potter, G David Gitajn, I Leah Chang, Gerard Phelps, Kevin D Kempton, Laurence B Karunakar, Madhav Jaeblon, Todd Demyanovich, Haley K Domes, Christopher M Kuhn, Gabrielle R Reilly, Rachel M Gage, Mark J Weaver, Michael J von Keudell, Arvind G Heng, Marilyn McTague, Michael F Alnasser, Ahmad Mehta, Samir Donegan, Derek J Natoli, Roman M Szatkowski, Jan Scott, Alesha N Shannon, Steven F Jeray, Kyle J Tanner, Stephanie L Marmor, Meir T Matityahu, Amir Fowler, Justin T Pierrie, Sarah N Beltran, Michael J Thomson, Cameron G Lin, Carol A Moon, Charles N Scolaro, John A Amirhekmat, Arya Leonard, Jordan Pogorzelski, David Bzovsky, Sofia Heels-Ansdell, Diane Szasz, Olivia P Gallant, Jodi L Della Rocca, Gregory J Zura, Robert D Hebden, Joan N Patterson, Joseph T Lee, Christopher O'Hara, Lyndsay M Marvel, Debra Palmer, Jana E Friedrich, Jeff D'Alleyrand, Jean-Claude G Rivera, Jessica C Mossuto, Franca Schrank, Gregory M Guyatt, Gordon Devereaux, P J Bhandari, Mohit |
| description | Skin antisepsis with iodine povacrylex resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in patients with closed limb fractures but not in those with open fractures. |
| doi_str_mv | 10.1056/NEJMoa2307679 |
| format | Article |
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Higgins, Thomas F ; Marchand, Lucas S ; Bergin, Patrick F ; Morellato, John ; Van Demark, 3rd, Robert E ; Potter, G David ; Gitajn, I Leah ; Chang, Gerard ; Phelps, Kevin D ; Kempton, Laurence B ; Karunakar, Madhav ; Jaeblon, Todd ; Demyanovich, Haley K ; Domes, Christopher M ; Kuhn, Gabrielle R ; Reilly, Rachel M ; Gage, Mark J ; Weaver, Michael J ; von Keudell, Arvind G ; Heng, Marilyn ; McTague, Michael F ; Alnasser, Ahmad ; Mehta, Samir ; Donegan, Derek J ; Natoli, Roman M ; Szatkowski, Jan ; Scott, Alesha N ; Shannon, Steven F ; Jeray, Kyle J ; Tanner, Stephanie L ; Marmor, Meir T ; Matityahu, Amir ; Fowler, Justin T ; Pierrie, Sarah N ; Beltran, Michael J ; Thomson, Cameron G ; Lin, Carol A ; Moon, Charles N ; Scolaro, John A ; Amirhekmat, Arya ; Leonard, Jordan ; Pogorzelski, David ; Bzovsky, Sofia ; Heels-Ansdell, Diane ; Szasz, Olivia P ; Gallant, Jodi L ; Della Rocca, Gregory J ; Zura, Robert D ; Hebden, Joan N ; Patterson, Joseph T ; Lee, Christopher ; O'Hara, Lyndsay M ; Marvel, Debra ; Palmer, Jana E ; Friedrich, Jeff ; D'Alleyrand, Jean-Claude G ; Rivera, Jessica C ; Mossuto, Franca ; Schrank, Gregory M ; Guyatt, Gordon ; Devereaux, P J ; Bhandari, Mohit ; The PREP-IT Investigators ; PREP-IT Investigators</creatorcontrib><description>Skin antisepsis with iodine povacrylex resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in patients with closed limb fractures but not in those with open fractures.</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMoa2307679</identifier><identifier>PMID: 38294973</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>2-Propanol - administration & dosage ; 2-Propanol - adverse effects ; 2-Propanol - therapeutic use ; Alcohol ; Anti-Infective Agents, Local - administration & dosage ; Anti-Infective Agents, Local - adverse effects ; Anti-Infective Agents, Local - therapeutic use ; Antisepsis - methods ; Bacterial Infections ; Bone healing ; Bone surgery ; Canada ; Chlorhexidine ; Chlorhexidine - administration & dosage ; Chlorhexidine - adverse effects ; Chlorhexidine - therapeutic use ; Cross-Over Studies ; Ethanol ; Extremities - injuries ; Extremities - microbiology ; Extremities - surgery ; Fracture Fixation ; Fractures ; Fractures, Bone - surgery ; Hospitals ; Humans ; Infectious Disease ; Infectious Disease General ; Intervention ; Iodine ; Iodine - administration & dosage ; Iodine - adverse effects ; Iodine - therapeutic use ; Isopropyl alcohol ; Open fractures ; Orthopedics ; Orthopedics General ; Patient safety ; Patients ; Preoperative Care - adverse effects ; Preoperative Care - methods ; Skin ; Skin - microbiology ; Surgeons ; Surgery ; Surgery General ; Surgical site infections ; Surgical Wound Infection - etiology ; Surgical Wound Infection - prevention & control ; United States</subject><ispartof>The New England journal of medicine, 2024-02, Vol.390 (5), p.409-420</ispartof><rights>Copyright © 2024 Massachusetts Medical Society. 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Mark J</creatorcontrib><creatorcontrib>Weaver, Michael J</creatorcontrib><creatorcontrib>von Keudell, Arvind G</creatorcontrib><creatorcontrib>Heng, Marilyn</creatorcontrib><creatorcontrib>McTague, Michael F</creatorcontrib><creatorcontrib>Alnasser, Ahmad</creatorcontrib><creatorcontrib>Mehta, Samir</creatorcontrib><creatorcontrib>Donegan, Derek J</creatorcontrib><creatorcontrib>Natoli, Roman M</creatorcontrib><creatorcontrib>Szatkowski, Jan</creatorcontrib><creatorcontrib>Scott, Alesha N</creatorcontrib><creatorcontrib>Shannon, Steven F</creatorcontrib><creatorcontrib>Jeray, Kyle J</creatorcontrib><creatorcontrib>Tanner, Stephanie L</creatorcontrib><creatorcontrib>Marmor, Meir T</creatorcontrib><creatorcontrib>Matityahu, Amir</creatorcontrib><creatorcontrib>Fowler, Justin T</creatorcontrib><creatorcontrib>Pierrie, Sarah N</creatorcontrib><creatorcontrib>Beltran, Michael J</creatorcontrib><creatorcontrib>Thomson, Cameron G</creatorcontrib><creatorcontrib>Lin, Carol 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C</creatorcontrib><creatorcontrib>Mossuto, Franca</creatorcontrib><creatorcontrib>Schrank, Gregory M</creatorcontrib><creatorcontrib>Guyatt, Gordon</creatorcontrib><creatorcontrib>Devereaux, P J</creatorcontrib><creatorcontrib>Bhandari, Mohit</creatorcontrib><creatorcontrib>The PREP-IT Investigators</creatorcontrib><creatorcontrib>PREP-IT Investigators</creatorcontrib><title>Skin Antisepsis before Surgical Fixation of Extremity Fractures</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>Skin antisepsis with iodine povacrylex resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in patients with closed limb fractures but not in those with open fractures.</description><subject>2-Propanol - administration & dosage</subject><subject>2-Propanol - adverse effects</subject><subject>2-Propanol - therapeutic use</subject><subject>Alcohol</subject><subject>Anti-Infective Agents, Local - administration & dosage</subject><subject>Anti-Infective Agents, Local - adverse effects</subject><subject>Anti-Infective Agents, Local - therapeutic use</subject><subject>Antisepsis - methods</subject><subject>Bacterial Infections</subject><subject>Bone healing</subject><subject>Bone surgery</subject><subject>Canada</subject><subject>Chlorhexidine</subject><subject>Chlorhexidine - administration & dosage</subject><subject>Chlorhexidine - adverse effects</subject><subject>Chlorhexidine - therapeutic use</subject><subject>Cross-Over Studies</subject><subject>Ethanol</subject><subject>Extremities - injuries</subject><subject>Extremities - microbiology</subject><subject>Extremities - surgery</subject><subject>Fracture Fixation</subject><subject>Fractures</subject><subject>Fractures, Bone - surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infectious Disease</subject><subject>Infectious Disease General</subject><subject>Intervention</subject><subject>Iodine</subject><subject>Iodine - administration & dosage</subject><subject>Iodine - adverse effects</subject><subject>Iodine - therapeutic use</subject><subject>Isopropyl alcohol</subject><subject>Open fractures</subject><subject>Orthopedics</subject><subject>Orthopedics General</subject><subject>Patient safety</subject><subject>Patients</subject><subject>Preoperative Care - adverse effects</subject><subject>Preoperative Care - methods</subject><subject>Skin</subject><subject>Skin - microbiology</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgery General</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - etiology</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>United 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Antisepsis before Surgical Fixation of Extremity Fractures</title><author>Sprague, Sheila ; Slobogean, Gerard ; Wells, Jeffrey L ; O'Hara, Nathan N ; Thabane, Lehana ; Mullins, C Daniel ; Harris, Anthony D ; Wood, Amber ; Viskontas, Darius ; Apostle, Kelly L ; O'Toole, Robert V ; Joshi, Manjari ; Johal, Herman ; Al-Asiri, Jamal ; Hymes, Robert A ; Gaski, Greg E ; Pilson, Holly T ; Carroll, Eben A ; Babcock, Sharon ; Halvorson, Jason J ; Romeo, Nicholas M ; Matson, Christopher A ; Higgins, Thomas F ; Marchand, Lucas S ; Bergin, Patrick F ; Morellato, John ; Van Demark, 3rd, Robert E ; Potter, G David ; Gitajn, I Leah ; Chang, Gerard ; Phelps, Kevin D ; Kempton, Laurence B ; Karunakar, Madhav ; Jaeblon, Todd ; Demyanovich, Haley K ; Domes, Christopher M ; Kuhn, Gabrielle R ; Reilly, Rachel M ; Gage, Mark J ; Weaver, Michael J ; von Keudell, Arvind G ; Heng, Marilyn ; McTague, Michael F ; Alnasser, Ahmad ; Mehta, Samir ; Donegan, Derek J ; Natoli, Roman M ; Szatkowski, Jan ; Scott, Alesha N ; Shannon, Steven F ; Jeray, Kyle J ; Tanner, Stephanie L ; Marmor, Meir T ; Matityahu, Amir ; Fowler, Justin T ; Pierrie, Sarah N ; Beltran, Michael J ; Thomson, Cameron G ; Lin, Carol A ; Moon, Charles N ; Scolaro, John A ; Amirhekmat, Arya ; Leonard, Jordan ; Pogorzelski, David ; Bzovsky, Sofia ; Heels-Ansdell, Diane ; Szasz, Olivia P ; Gallant, Jodi L ; Della Rocca, Gregory J ; Zura, Robert D ; Hebden, Joan N ; Patterson, Joseph T ; Lee, Christopher ; O'Hara, Lyndsay M ; Marvel, Debra ; Palmer, Jana E ; Friedrich, Jeff ; D'Alleyrand, Jean-Claude G ; Rivera, Jessica C ; Mossuto, Franca ; Schrank, Gregory M ; Guyatt, Gordon ; Devereaux, P J ; Bhandari, Mohit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-d328ec0d28b2b577fd41aecbce2bdbdf3e909eeaf58c2e2f0814d85b32348db03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>2-Propanol - administration & dosage</topic><topic>2-Propanol - adverse effects</topic><topic>2-Propanol - therapeutic use</topic><topic>Alcohol</topic><topic>Anti-Infective Agents, Local - administration & dosage</topic><topic>Anti-Infective Agents, Local - adverse effects</topic><topic>Anti-Infective Agents, Local - therapeutic use</topic><topic>Antisepsis - methods</topic><topic>Bacterial Infections</topic><topic>Bone healing</topic><topic>Bone surgery</topic><topic>Canada</topic><topic>Chlorhexidine</topic><topic>Chlorhexidine - administration & dosage</topic><topic>Chlorhexidine - adverse effects</topic><topic>Chlorhexidine - therapeutic use</topic><topic>Cross-Over Studies</topic><topic>Ethanol</topic><topic>Extremities - injuries</topic><topic>Extremities - microbiology</topic><topic>Extremities - surgery</topic><topic>Fracture Fixation</topic><topic>Fractures</topic><topic>Fractures, Bone - surgery</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infectious Disease</topic><topic>Infectious Disease General</topic><topic>Intervention</topic><topic>Iodine</topic><topic>Iodine - administration & dosage</topic><topic>Iodine - adverse effects</topic><topic>Iodine - therapeutic use</topic><topic>Isopropyl alcohol</topic><topic>Open fractures</topic><topic>Orthopedics</topic><topic>Orthopedics General</topic><topic>Patient safety</topic><topic>Patients</topic><topic>Preoperative Care - adverse effects</topic><topic>Preoperative Care - methods</topic><topic>Skin</topic><topic>Skin - microbiology</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgery General</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - etiology</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sprague, Sheila</creatorcontrib><creatorcontrib>Slobogean, Gerard</creatorcontrib><creatorcontrib>Wells, Jeffrey L</creatorcontrib><creatorcontrib>O'Hara, Nathan N</creatorcontrib><creatorcontrib>Thabane, Lehana</creatorcontrib><creatorcontrib>Mullins, C Daniel</creatorcontrib><creatorcontrib>Harris, Anthony D</creatorcontrib><creatorcontrib>Wood, Amber</creatorcontrib><creatorcontrib>Viskontas, Darius</creatorcontrib><creatorcontrib>Apostle, Kelly L</creatorcontrib><creatorcontrib>O'Toole, Robert V</creatorcontrib><creatorcontrib>Joshi, Manjari</creatorcontrib><creatorcontrib>Johal, Herman</creatorcontrib><creatorcontrib>Al-Asiri, Jamal</creatorcontrib><creatorcontrib>Hymes, Robert A</creatorcontrib><creatorcontrib>Gaski, Greg E</creatorcontrib><creatorcontrib>Pilson, Holly T</creatorcontrib><creatorcontrib>Carroll, Eben A</creatorcontrib><creatorcontrib>Babcock, Sharon</creatorcontrib><creatorcontrib>Halvorson, Jason J</creatorcontrib><creatorcontrib>Romeo, Nicholas M</creatorcontrib><creatorcontrib>Matson, Christopher A</creatorcontrib><creatorcontrib>Higgins, Thomas F</creatorcontrib><creatorcontrib>Marchand, Lucas S</creatorcontrib><creatorcontrib>Bergin, Patrick F</creatorcontrib><creatorcontrib>Morellato, John</creatorcontrib><creatorcontrib>Van Demark, 3rd, Robert E</creatorcontrib><creatorcontrib>Potter, G David</creatorcontrib><creatorcontrib>Gitajn, I Leah</creatorcontrib><creatorcontrib>Chang, Gerard</creatorcontrib><creatorcontrib>Phelps, Kevin D</creatorcontrib><creatorcontrib>Kempton, Laurence B</creatorcontrib><creatorcontrib>Karunakar, Madhav</creatorcontrib><creatorcontrib>Jaeblon, Todd</creatorcontrib><creatorcontrib>Demyanovich, Haley K</creatorcontrib><creatorcontrib>Domes, Christopher M</creatorcontrib><creatorcontrib>Kuhn, Gabrielle R</creatorcontrib><creatorcontrib>Reilly, Rachel M</creatorcontrib><creatorcontrib>Gage, Mark J</creatorcontrib><creatorcontrib>Weaver, Michael J</creatorcontrib><creatorcontrib>von Keudell, Arvind G</creatorcontrib><creatorcontrib>Heng, Marilyn</creatorcontrib><creatorcontrib>McTague, Michael 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Amber</au><au>Viskontas, Darius</au><au>Apostle, Kelly L</au><au>O'Toole, Robert V</au><au>Joshi, Manjari</au><au>Johal, Herman</au><au>Al-Asiri, Jamal</au><au>Hymes, Robert A</au><au>Gaski, Greg E</au><au>Pilson, Holly T</au><au>Carroll, Eben A</au><au>Babcock, Sharon</au><au>Halvorson, Jason J</au><au>Romeo, Nicholas M</au><au>Matson, Christopher A</au><au>Higgins, Thomas F</au><au>Marchand, Lucas S</au><au>Bergin, Patrick F</au><au>Morellato, John</au><au>Van Demark, 3rd, Robert E</au><au>Potter, G David</au><au>Gitajn, I Leah</au><au>Chang, Gerard</au><au>Phelps, Kevin D</au><au>Kempton, Laurence B</au><au>Karunakar, Madhav</au><au>Jaeblon, Todd</au><au>Demyanovich, Haley K</au><au>Domes, Christopher M</au><au>Kuhn, Gabrielle R</au><au>Reilly, Rachel M</au><au>Gage, Mark J</au><au>Weaver, Michael J</au><au>von Keudell, Arvind G</au><au>Heng, Marilyn</au><au>McTague, Michael F</au><au>Alnasser, Ahmad</au><au>Mehta, Samir</au><au>Donegan, Derek J</au><au>Natoli, Roman M</au><au>Szatkowski, Jan</au><au>Scott, Alesha N</au><au>Shannon, Steven F</au><au>Jeray, Kyle J</au><au>Tanner, Stephanie L</au><au>Marmor, Meir T</au><au>Matityahu, Amir</au><au>Fowler, Justin T</au><au>Pierrie, Sarah N</au><au>Beltran, Michael J</au><au>Thomson, Cameron G</au><au>Lin, Carol A</au><au>Moon, Charles N</au><au>Scolaro, John A</au><au>Amirhekmat, Arya</au><au>Leonard, Jordan</au><au>Pogorzelski, David</au><au>Bzovsky, Sofia</au><au>Heels-Ansdell, Diane</au><au>Szasz, Olivia P</au><au>Gallant, Jodi L</au><au>Della Rocca, Gregory J</au><au>Zura, Robert D</au><au>Hebden, Joan N</au><au>Patterson, Joseph T</au><au>Lee, Christopher</au><au>O'Hara, Lyndsay M</au><au>Marvel, Debra</au><au>Palmer, Jana E</au><au>Friedrich, Jeff</au><au>D'Alleyrand, Jean-Claude G</au><au>Rivera, Jessica C</au><au>Mossuto, Franca</au><au>Schrank, Gregory M</au><au>Guyatt, Gordon</au><au>Devereaux, P J</au><au>Bhandari, Mohit</au><aucorp>The PREP-IT Investigators</aucorp><aucorp>PREP-IT Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Skin Antisepsis before Surgical Fixation of Extremity Fractures</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>390</volume><issue>5</issue><spage>409</spage><epage>420</epage><pages>409-420</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>Skin antisepsis with iodine povacrylex resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in patients with closed limb fractures but not in those with open fractures.</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>38294973</pmid><doi>10.1056/NEJMoa2307679</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-4047-6818</orcidid><orcidid>https://orcid.org/0000-0003-4322-2490</orcidid><orcidid>https://orcid.org/0000-0003-2935-637X</orcidid><orcidid>https://orcid.org/0000-0002-4182-3244</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2024-02, Vol.390 (5), p.409-420 |
| issn | 0028-4793 1533-4406 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2921117094 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; New England Journal of Medicine |
| subjects | 2-Propanol - administration & dosage 2-Propanol - adverse effects 2-Propanol - therapeutic use Alcohol Anti-Infective Agents, Local - administration & dosage Anti-Infective Agents, Local - adverse effects Anti-Infective Agents, Local - therapeutic use Antisepsis - methods Bacterial Infections Bone healing Bone surgery Canada Chlorhexidine Chlorhexidine - administration & dosage Chlorhexidine - adverse effects Chlorhexidine - therapeutic use Cross-Over Studies Ethanol Extremities - injuries Extremities - microbiology Extremities - surgery Fracture Fixation Fractures Fractures, Bone - surgery Hospitals Humans Infectious Disease Infectious Disease General Intervention Iodine Iodine - administration & dosage Iodine - adverse effects Iodine - therapeutic use Isopropyl alcohol Open fractures Orthopedics Orthopedics General Patient safety Patients Preoperative Care - adverse effects Preoperative Care - methods Skin Skin - microbiology Surgeons Surgery Surgery General Surgical site infections Surgical Wound Infection - etiology Surgical Wound Infection - prevention & control United States |
| title | Skin Antisepsis before Surgical Fixation of Extremity Fractures |
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