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Reducing surgical infections

Your mother was right: wash your hands and you'll live a clean life.

Two new multicenter studies published in the New England Journal of Medicine on Jan. 7, and reported in the New York Times, take that homily to heart, showing that cleanliness is critical for people who are going into the hospital for surgery--and that screening and scrubbing pre-surgical patients can help to prevent some common infections.

In one study, some 500 patients who were scheduled for surgery and tested positive with nasal swabs for a common bacteria, staphylococcus aureus, were treated with an antibiotic ointment and special soap within 24 hours of being admitted to the hospital. After surgery, they were 60 percent less likely to develop infections than patients who were given a placebo ointment and soap.

In the second study, some 800 patients whose skin was cleaned with a special chlorhexidine-alcohol solution prior to surgery got 40 percent fewer infections than those who were scrubbed with a standard disinfectant.

Writing in a NEJM editorial, Richard P. Wenzel, MD, an infectious disease specialist at Virginia Commonwealth University, noted that the Centers for Disease Control and Prevention have long recommended chlorhexidine-alcohol as a prophylactic approach. Both studies, he added, "offer remarkably safer strategies for all patients who require surgery."

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