Preliminary analysis of the antimicrobial activity of a novel surgical incise drape containing chlorhexidine gluconate against methicillin-resistant Staphylococcus aureus (MRSA) in an in vivo porcine, incisional-wound model

Abstract

Background: Surgical site infections occur in at least 2%-4% of all patients. A proposed, risk-reduction strategy has been the use of adhesive, plastic incise drapes to reduce the risk of surgical site infection. The present investigation reports the efficacy of a novel chlorhexidine gluconate (CHG) adhesive surgical drape to reduce the risk of horizontal bacterial migration into surgical wounds, using a porcine model of wound contamination.

Methods: Using a standardized inoculum, and a predetermined randomization schedule, a porcine model was used to assess the efficacy of a CHG-impregnated adhesive drape to prevent MRSA contamination of a simulated surgical wound and intact skin surface compared with an iodophor-impregnated incise drape and a nonantimicrobial incise drape in 0, 1, and 4-hour surgeries.

Results: MRSA recovery from incisional wounds was lowest in sites treated with the CHG drape. The difference was statistically significant (P < .001) at all time points, both between the CHG drape and the nonantimicrobial control as well as between the CHG and iodophor drapes. Mean MRSA recovery from wounds treated with iodophor drapes was slightly lower than nonantimicrobial drapes. The difference was not statistically significant at 0- or 1-hour (P = .065 and P = .089, respectively), however the differences were significant at 4-hours (P = .024).

Discussion: These preliminary results show that a novel CHG surgical incise drape reduced MRSA contamination of a surgical incision site and showed significant antimicrobial activity against contamination of intact skin surfaces compared with an iodophor- impregnated drape.

Conclusions: A novel CHG surgical drape was effective in significantly reducing MRSA contamination in an incisional wound model. Future studies are needed to assess its clinical efficacy.

Keywords: CHG; Iodophor; Porcine animal model; Surgical drape; Surgical site infection.