CLINICAL EFFICACY OF A CHLOROUS ACID PREOPERATIVE SKIN ANTISEPTIC

Background: Among the ways to reduce the incidence of iatrogenic infec tious disease is the use of efficacious preoperative antiseptics. Iodo phors and chlorhexidines, the chief presurgical disinfectants today, h ave various problems with practicality. A new preoperative skin antise ptic has been developed (Alcide Corporation, Redmond, Wash) that invol ves the mixture of a 0.1% sodium chlorite formulation and an activatin g preparation of 0.5% mandelic acid to produce chlorous acid and other antimicrobial degradation products. Methods: Under clinical condition s, the antimicrobial effectiveness of this blended preparation was com pared with a chlorhexidine gluconate scrub solution. Using a Latin-squ are randomization scheme, we treated 2 contralateral abdominal sites a nd 2 contralateral inguinal sites of healthy male and female volunteer s with these antiseptics or the controls of vehicle or activator alone . Microorganisms were harvested and quantified by a standard cylinder- scrub technique. Results: Of 85 volunteers (170 possible sites per tes t region) screened to meet the US Food and Drug Administration baselin e criteria on population densities of normal flora, 61 abnominal 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 norm al flora at 10 minutes, 30 minutes, and 6 hours after treatment. As ma ny as 3 log reductions were achieved, and activity persisted as long a s 6 hours. Compared with chlorhexidine, the chlorous acid product has the practical advantages of a shelter scrub time, less foam, air dryin g (instead of wiping), and no perceivable residue. Conclusions: An act ivated chlorous acid product statistically matched the performance of chlorhexidine gluconate in reducing populations of resident flora on t reated skin sites. With an easier and shorter application procedure an d strong, long-term antimicrobial activity, this new halogenated antis eptic seems to be a useful and possible efficacious preoperative skin disinfectant.