The Effect of Number of Showers With 4% Chlorhexidine Gluconate on Prevention of Surgical Site Infections
NCT ID: NCT06801275
Last Updated: 2025-09-17
Study Results
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Basic Information
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ACTIVE_NOT_RECRUITING
NA
86 participants
INTERVENTIONAL
2024-07-01
2025-12-15
Brief Summary
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Although lumbar disc herniation (LDH), which is one of the common cases in neurosurgery, is a serious problem affecting postoperative SSI, morbidity and mortality, there are not enough studies on its prevention in the literature.
In the literature, there are studies on showering with chlorhexidine or other antiseptic solutions in the preoperative period to prevent SSI, but there is no study on whether the number of showers performed in the preoperative period is effective on SSI.
In this study, the effect of showering with 4% chlorhexidine gluconate before lumbar disc herniation surgery on postoperative surgical site infections will be examined. It is aimed to compare the effect of douching with 4% Chlorhexidine Gluconate before lumbar disc hernia surgery on surgical site infections. Since there are not enough studies in the literature, this study is an innovative study. In this study, it is thought that washing the surgical site with antiseptic soap containing 4% Chlorhexidine Gluconate before LDH surgery will have an effect on surgical site infections.
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Detailed Description
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Although the incidence of SSI after LDH surgery is not known with certainty, patients usually have various potential risk factors for CAI such as advanced age, malnutrition due to loss of appetite, and steroid use. All surgical patients are at risk for developing SSI. For patients, SSI can cause pain and discomfort, financial losses, and impaired quality of life. These infections can lead from a simple incision site abscess with purulent discharge to a complex infection that can contribute to a life-threatening condition and possible morbidity. Therefore, accurate monitoring of SSI and confirmation of the diagnosis of SSI are very important and vital for patients.
The main causative microorganisms of SSI in the preoperative period are gram-positive cocci, which are common bacterial colonies of the skin. Therefore, although WHO recommends showering with normal or antiseptic soap before surgical intervention, it is thought that the use of antiseptic soap will be more effective to destroy a larger number of skin pathogens both before and during surgical intervention.. For this reason, it was deemed appropriate to wash the surgical areas of the patients with antiseptic soap containing 4% chlorhexidine gluconate before surgery.
In the literature, there are studies showing that many factors related to the perioperative process and surgical procedure increase the risk of developing SSI. Among these, there are studies showing that bathing with an antimicrobial agent before surgical intervention reduces the overall bacterial load in the skin's own flora, thus reducing the risk of SSI.
Although there are evidence-based recommendations and some improved care practices to prevent SSI in the literatüre, there is no standardised practice with proven efficacy today. This study is a randomised controlled experimental design and requires a team approach consisting of physicians and nurses in line with the existing evidence recommendations. Therefore, it is thought that showering the operation area with antiseptic soap containing 4% Chlorhexidine Gluconate before lumbar disc herniation surgery will be effective in reducing SSI.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
SINGLE
Study Groups
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The effect of 1 shower with 4% chlorhexidine gluconate on surgical site infections
Patients will be showered with 4% chlorhexidine gluconate 1 time on the night before surgery.
1 shower with 4% chlorhexidine gluconate
Comparison of the effect of showering once with 4% Chlorhexidine Gluconate before lumbar disc herniation surgery on surgical site infections
The effect of 2 shower with 4% chlorhexidine gluconate on surgical site infections
patients will be provided to shower with 4% chlorhexidine gluconate twice, the night before and the morning of the operation.
2 shower with 4% chlorhexidine gluconate
Comparison of the effect of showering twice with 4% Chlorhexidine Gluconate before lumbar disc herniation surgery on surgical site infections
Interventions
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1 shower with 4% chlorhexidine gluconate
Comparison of the effect of showering once with 4% Chlorhexidine Gluconate before lumbar disc herniation surgery on surgical site infections
2 shower with 4% chlorhexidine gluconate
Comparison of the effect of showering twice with 4% Chlorhexidine Gluconate before lumbar disc herniation surgery on surgical site infections
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
18 Years
65 Years
ALL
Yes
Sponsors
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Çanakkale Onsekiz Mart University
OTHER
Responsible Party
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Araz ASKEROĞLU
Assoc. Prof. D.
Principal Investigators
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araz askeroğlu
Role: STUDY_DIRECTOR
çanakkale on sekiz mart university
Locations
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Çanakkale on Sekiz Mart University
Çanakkale, Merkez, Turkey (Türkiye)
Çanakkale on Sekiz Mart Üniversity
Çanakkale, Merkez, Turkey (Türkiye)
Countries
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References
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Sway A, Solomkin JS, Pittet D, Kilpatrick C. Methodology and Background for the World Health Organization Global Guidelines on the Prevention of Surgical Site Infection. Surg Infect (Larchmt). 2018 Jan;19(1):33-39. doi: 10.1089/sur.2017.076. Epub 2017 May 4.
Young H, Bliss R, Carey JC, Price CS. Beyond core measures: identifying modifiable risk factors for prevention of surgical site infection after elective total abdominal hysterectomy. Surg Infect (Larchmt). 2011 Dec;12(6):491-6. doi: 10.1089/sur.2010.103. Epub 2011 Dec 5.
McClelland S 3rd, Hall WA. Postoperative central nervous system infection: incidence and associated factors in 2111 neurosurgical procedures. Clin Infect Dis. 2007 Jul 1;45(1):55-9. doi: 10.1086/518580. Epub 2007 May 21.
Abode-Iyamah KO, Chiang HY, Winslow N, Park B, Zanaty M, Dlouhy BJ, Flouty OE, Rasmussen ZD, Herwaldt LA, Greenlee JD. Risk factors for surgical site infections and assessment of vancomycin powder as a preventive measure in patients undergoing first-time cranioplasty. J Neurosurg. 2018 Apr;128(4):1241-1249. doi: 10.3171/2016.12.JNS161967. Epub 2017 May 12.
Aldrich A, Kuss MA, Duan B, Kielian T. 3D Bioprinted Scaffolds Containing Viable Macrophages and Antibiotics Promote Clearance of Staphylococcus aureus Craniotomy-Associated Biofilm Infection. ACS Appl Mater Interfaces. 2019 Apr 3;11(13):12298-12307. doi: 10.1021/acsami.9b00264. Epub 2019 Mar 21.
AORN. (2014). Preoperative Standards and Recommended Practices. Denver, CO: AORN, pp. 445-463.
Berrios-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, Reinke CE, Morgan S, Solomkin JS, Mazuski JE, Dellinger EP, Itani KMF, Berbari EF, Segreti J, Parvizi J, Blanchard J, Allen G, Kluytmans JAJW, Donlan R, Schecter WP; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017 Aug 1;152(8):784-791. doi: 10.1001/jamasurg.2017.0904.
Damkliang J, Considine J, Kent B, Street M. Nurses' perceptions of using an evidence-based care bundle for initial emergency nursing management of patients with severe traumatic brain injury: A qualitative study. Int Emerg Nurs. 2015 Oct;23(4):299-305. doi: 10.1016/j.ienj.2015.04.004. Epub 2015 Jun 3.
Edmiston CE Jr, Leaper D. Should preoperative showering or cleansing with chlorhexidine gluconate (CHG) be part of the surgical care bundle to prevent surgical site infection? J Infect Prev. 2017 Nov;18(6):311-314. doi: 10.1177/1757177417714873. Epub 2017 Jul 26.
Liu H, Dong X, Yin Y, Chen Z, Zhang J. Reduction of Surgical Site Infections After Cranioplasty With Perioperative Bundle. J Craniofac Surg. 2017 Sep;28(6):1408-1412. doi: 10.1097/SCS.0000000000003650.
Other Identifiers
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2024-116
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
20240703591
Identifier Type: -
Identifier Source: org_study_id
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