Efficacy of Surgical Skin Preparation Solutions in Hip Arthroplasty Surgery

June 28, 2019 updated by: Kurt Droll, Lakehead University
This study will assess the efficacy of two of the most commonly used surgical skin-preparation solutions: Chloraprep (chlorhexidine-alcohol) and Duraprep (iodine-alcohol) at eliminating bacteria from the hip site by evaluating the residual bacteria present following surgical skin-preparation.

Study Overview

Detailed Description

Post-operative infections, although rare, can lead to significant patient morbidity and cost. A potential risk factor for the development of post-operative wound infection is the amount of bacterial skin flora present at the operative site at the time of surgery. Therefore, the use of an effective anti-microbial preoperative skin-preparation solution is essential in preventing the contamination of the surgical site and in turn the surgical wound.

Several different types of anti-microbial skin preparation solutions are presently used pre-operatively. However, there is currently no consensus on which solution is superior. Previous studies have investigated the efficacy of commonly used solutions in the shoulder, foot and spine, however the bacterial flora from these areas are likely different from the hip region. Thus the findings in the literature are not necessarily applicable to surgery involving the hip.

Because of the potentially devastating consequences of a surgical wound infection, ensuring effective skin preparation prior to surgery is critical. Therefore the identification of a superior skin-preparation solution for the elimination of bacterial pathogens, specific to the hip region, could potentially have considerable impact on the clinical care of patients undergoing hip arthroplasty surgery.

This study will assess the efficacy of two of the most commonly used surgical skin-preparation solutions: Chloraprep (chlorhexidine-alcohol) and Duraprep (iodine-alcohol), at eliminating bacteria from the hip site by evaluating the residual bacteria present following surgical skin-preparation.The primary outcome is as follows: positive culture rates of residual bacteria following surgical skin preparation. Secondary outcomes that will be evaluated is culture rates post-surgery (following skin closure) and acute (within 3 months) post-operative wound complications.

Study Type

Interventional

Enrollment (Actual)

105

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • ADULT
  • OLDER_ADULT
  • CHILD

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Has consented for primary total hip arthroplasty by any of the following orthopaedic surgeons: Drs. Kurt Droll, Dave Puskas or Claude Cullinan
  • Are capable of providing their own consent
  • Are able to adequately communicate in English to undergo informed consent
  • Has provided written, informed consent for the study

Exclusion Criteria:

  • Previous hip arthroplasty
  • Evidence of an open wound at the incision site
  • Evidence of an abrasion in the vicinity of the planned incision
  • Evidence of an active infection at or near the surgical site
  • Evidence of an active infection elsewhere in the body
  • Are chronically immunosuppressed e.g. transplant
  • Is deemed not suitable for the study in the opinion of an investigator

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Duraprep Surgical Solution
Surgical site (hip) is prepared with Duraprep (iodine-alcohol) prior to surgery according to package instructions.
DuraPrep surgical solution
Other Names:
  • Iodine Povacrylex and Isopropyl Alcohol
EXPERIMENTAL: Chloraprep Surgical Solution
Surgical site (hip) is prepared with Chloraprep (chlorhexidine-alcohol) prior to surgery according to package instructions.
ChloraPrep surgical solution
Other Names:
  • chlorhexidine-alcohol

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-preparation skin swab
Time Frame: 4 minutes post-skin preparation
bacterial culture rates following surgical skin preparation
4 minutes post-skin preparation

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-operative skin swab
Time Frame: immediately after closure of the incision, before drape is removed from operative site
bacterial culture rates following surgery
immediately after closure of the incision, before drape is removed from operative site
Post-operative wound complications
Time Frame: 3 months post-surgery
wound complications at follow-up
3 months post-surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Kurt Droll, MD, TBRHSC

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

October 29, 2014

Primary Completion (ACTUAL)

January 7, 2016

Study Completion (ACTUAL)

April 6, 2016

Study Registration Dates

First Submitted

January 3, 2018

First Submitted That Met QC Criteria

January 8, 2018

First Posted (ACTUAL)

January 9, 2018

Study Record Updates

Last Update Posted (ACTUAL)

July 1, 2019

Last Update Submitted That Met QC Criteria

June 28, 2019

Last Verified

June 1, 2019

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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