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Am J Infect Control · Aug 1998
Randomized Controlled Trial Comparative Study Clinical TrialClinical efficacy of a chlorous acid preoperative skin antiseptic.
- R Aly, C Bayles, D J Bibel, H I Maibach, and C A Orsine.
- Department of Dermatology, University of California, San Francisco 94143-0517, USA.
- Am J Infect Control. 1998 Aug 1;26(4):406-12.
BackgroundAmong the ways to reduce the incidence of iatrogenic infectious disease is the use of efficacious preoperative antiseptics. Iodophors and chlorhexidines, the chief presurgical disinfectants today, have various problems with practicality. A new preoperative skin antiseptic has been developed (Alcide Corporation, Redmond, Wash) that involves the mixture of a 0.1% sodium chlorite formulation and an activating preparation of 0.5% mandelic acid to produce chlorous acid and other antimicrobial degradation products.MethodsUnder clinical conditions, the antimicrobial effectiveness of this blended preparation was compared with a chlorhexidine gluconate scrub solution. Using a Latin-square randomization scheme, we treated 2 contralateral abdominal sites and 2 contralateral inguinal sites of healthy male and female volunteers with these antiseptics or the controls of vehicle or activator alone. Microorganisms were harvested and quantified by a standard cylinder-scrub technique.ResultsOf 85 volunteers (170 possible sites per test region) screened to meet the USA Food and Drug Administration baseline criteria on population densities of normal flora, 61 abnormal sites and 107 inguinal sites provided suitable data. Against chlorhexidine, the chlorous acid presurgical skin preparation produced superior but statistically equivalent reductions (P > .05) of each volunteer's normal flora at 10 minutes, 30 minutes, and 6 hours after treatment. As many as 4 log reductions were achieved, and activity persisted as long as 6 hours. Compared with chlorhexidine, the chlorous acid product has the practical advantages of a shorter scrub time, less foam, air drying (instead of wiping), and no perceivable residue.ConclusionsAn activated chlorous acid product statistically matched the performance of chlorhexidine gluconate in reducing populations of resident flora on treated skin sites. With an easier and shorter application procedure and strong, long-term antimicrobial activity, the new halogenated antiseptic seems to be a useful and possible efficacious preoperative skin disinfectant.
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