Why skin preparation matters

Patients' skin dwelling bacteria:

  • No. 1 Risk Factor for catheter-related bloodstream infections (CR-BSI)
  • No. 1 Pathogenic Agent for clean & clean-contaminated surgical site infections (SSI)

(Surveillance of Hospital-Acquired Bacteraemia in English Hospitals 1997-2002 NINSS Nosocomial Infection National Surveillance Service)

skin demonstration

Significance of pathogenic or normal resident flora:

  • On a single square centimetre of skin, there can be as many as 10 million aerobic bacteria 1
  • 80% of microorganisms reside in the first five cell layers of the epidermis 2
  • Historically, infection prevention measures have focused on asepsis of healthcare providers and the environment
  • Emerging evidence about the role played by the patient's own skin is changing the paradigm. 3

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  1. Microbial Ecology of Human Skin in Health and Disease, Fredericks DN, J Invest Dermatol Symp Proc 2001; 6: 167-9
  2. Effect of topical antimicrobial treatment on aerobic bacteria in the stratum corneum of human skin, Hendley JO, Ashe KM, Antimicrob Agents, Chemother 1991; 35: 627-31
  3. Chlorhexidine: Expanding the armamentarium for infection control and prevention, Milstone AM, Passaretti CL, Perl TM, CID 2008; 46: 274-80

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