2. Duration of action
There is little data to suggest any one is better than any other.
Rapid onset, good spectrum, modestly long duration.
But dries skin and flammable.
Betadine / Providine-iodine
Kills 99%, good spectrum.
Minimal irritation, but short duration of action.
Poor against viruses and TB, otherwise good spectrum.
Safe with good duration of activity.
Kills 99.9% of microbes.
Severely toxic if contacts middle ear or cornea.
Long acting, but poor vs gram -ves
And actively absorbed, can lead to CNS toxicity.
5 minutes is long enough.
- in fact in-vitro, 1 minute is enough (1).
A 3-5 minute scrub for the first and 2-3 minutes subsequently is
1. A pre-op shower on the evening before with chlorhexidine is
2. Remove hair immediately prior to the operation - if earlier,
bacteria grow in the nicks and infection rates increase
- use clippers, not razor.
- hair does not contribute to higher infection rates, so only remove if
it interferes with the operation or closure.
3. Mechanical wash: vigorously wash with soap-based iodophore or scrub
to remove contaminants, in spiral-outward motion.
- thoroughly wash the umbilicus.
4. New sponge; paint with disinfectant.\
Surg Gynecol Obstet 1969;129:1181.
Deitch. Tools of the Trade.