Incise Draping Reduces the Rate of Contamination of the Surgical Site During Hip Surgery: A Prospective, Randomized Trial.
BACKGROUND
Iodophor-impregnated adhesive incise drapes are widely used during surgeries for reducing surgical site contamination. There is little evidence to support the latter belief. This study evaluated the efficacy of iodophor-impregnated adhesive drapes for reducing bacterial contamination and counts at the incision site during hip surgery.


METHODS
In this prospective, randomized clinical trial, we enrolled 101 patients undergoing open joint preservation procedure of the hip. Half the patients had the adhesive drape applied to the skin prior to incision, while the remainder underwent the same surgery without a drape. Culture swabs were taken from the surgical site at 5 points (preskin preparation, after skin preparation, postincision, before subcutaneous closure, prior to dressing application) and sent for culture and colony counts. Mixed-effects logistic regressions were used to estimate effects of time and drape application on contamination rate.


RESULTS
At the conclusion of surgery, 12.0% of incisions with adhesive drapes and 27.4% without adhesive drapes were positive for bacterial colonization. When controlling for preoperative colonization and other factors, patients without adhesive drapes were significantly more likely to have bacteria present at the time of skin closure, and at all time points when swab cultures were taken.


CONCLUSION
It appears that the iodophor-impregnated adhesive draping significantly reduces bacterial colonization of the incision. Bacterial count at the skin was extremely high in some patients in whom adhesive drapes were not used, raising the possibility that a subsequent surgical site infection or periprosthetic joint infection could arise had an implant been utilized.
['Rezapoor|Maryam|M|', 'Tan|Timothy L|TL|', 'Maltenfort|Mitchell G|MG|', 'Parvizi|Javad|J|']
D000328:Adult D019644:Arthroplasty, Replacement, Hip D001424:Bacterial Infections D001458:Bandages D005260:Female D006801:Humans D007466:Iodophors D008297:Male D008875:Middle Aged D011446:Prospective Studies D019651:Reconstructive Surgical Procedures D012867:Skin D013501:Surface-Active Agents D058636:Surgical Drapes D013530:Surgical Wound Infection D055815:Young Adult
hip surgery iodophor-impregnated adhesive drapes bacterial contamination bacterial counts surgical site infection