Abstract
Objectives Chlorhexidine is seen as the golden standard of disinfectants. It is widely used to clean surgical sites. Many articles indicate resistance of pathogens to chlorhexidine. One study indicated that pathogenic micro-organisms were isolated from the soft palate cleft region in 57% of patients with facial clefts. The objective was to determine if chlorhexidine application is effective in removing pathogens from the surgical site in these patients. Secondly, if any pathogens were isolated, are they resistant to any other antimicrobials.
Design A descriptive observational study was designed and all patients (N = 50) that presented for primary repair of the soft palate cleft were included in the study. The average age of patients is 7 months and 16 days with 25 male and 25 female.
Settings A private practice that specializes in facial cleft surgery, with a country wide patient base was the research site. All procedures were executed by one Oral and Maxillofacial surgeon.
Participants All patients that presented for primary repair of the soft palate cleft were included in the study. Inclusion criteria: written consent from parents, and patients cleared as systemic healthy by a pediatric physician.
Methods Swabs were taken from the surgical site of all 50 patients with cleft soft palate and were sent for culture, identification and antimicrobial sensitivity. The swabs were taken before disinfecting the site as well as after 2 minutes of disinfecting the surgical site with Chlorhexidine. Results were compared against each other.
Results Forty seven patients showed positive cultures with 28 different pathogenic micro-organisms that were identified before cleaning the surgical site with the chlorhexidine. The most dominant pathogens were K pneumonia (n= 22), H influenza (n=18) and S aureus (n=10). Thirteen of the 28 pathogens were still present on the second swabs taken after disinfecting with chlorhexidine. K pneumonia (n= 13), H influenza (n=11) and S aureus (n=9) were still the most prevalent pathogens.
Conclusions This study demonstrated that 61 of the total of 113 pathogens isolated (54%), survived after 2 minutes of disinfecting the surgical and surrounding area with CHG, thus intensifying the chances of post-operative infection.
- Received September 7, 2017.
- Revision received November 1, 2017.
- Revision received February 20, 2018.
- Accepted March 23, 2018.
