Comparison of hydroalcoholic rubbing and conventional chlorhexidine scrubbing for aseptic skin preparation in dogs

Abstract

Objective: To compare preparation time, ease of application, and elimination of skin contamination of 3 skin preparation methods for asepsis.

Study design: Experimental study.

Animals: Healthy dogs (n = 6) with no clinical signs of skin disease.

Methods: Three sites on each dog were randomly allocated to 1 of 3 preparation protocols for asepsis: (1) 5 scrubbings with chlorhexidine gluconate and rinsing (CHXG), (2) washing with mild soap prior to 3 rubbings with hydroalcoholic solution (soap-HAR), or (3) 3 rubbings with hydroalcoholic solution (HAR). The duration of each method of skin preparation was recorded. A Count-Tact agar plate was placed in the center of each site before, immediately after, 1 hour after, and 3 hours after antiseptic application. Plates were cultured, and colony forming units (CFU) were counted.

Results: Skin preparation lasted an average of 375 seconds for CHXG, 240 seconds for soap-HAR, and 190 seconds for HAR (P = .00049). Nine CFU (median) were cultured from the skin prior to preparation, with no difference between sites on any animal or for any method. Colony forming units were not detected at any time on any site in any dog after antiseptic application.

Conclusion: Rubbing with hydroalcoholic (HA) solution was as effective as CHXG and prevented bacterial growth for at least 3 hours under these experimental conditions. Rubbing with hydroalcoholic solution was also faster and easier to perform.

Clinical significance: Because there is currently no known resistance to HA solution, preparation of the surgical site with HAR should be considered to prevent the emergence of bacterial resistance to chlorhexidine as well as potential cross-resistances to antibiotics. Transfer to clinical animals requires additional investigation.