Effectiveness of chlorhexidine in preventing infections among patients undergoing cardiac surgeries: a meta-analysis and systematic review.

BACKGROUND: Although several meta-analyses reported the impact of chlorhexidine (CHX) use in patients undergoing various types of surgery, no meta-analysis summarized the overall effectiveness of CHX specifically for cardiac surgery. This meta-analysis aimed to examine the impact of CHX on infections after cardiac surgery compared with other cleansers or antiseptics. METHODS: PubMed, Embase, and the Cochrane Library were searched from inception up to October 2020 for potentially eligible studies: (1) population: patients who underwent cardiac surgery; (2) intervention or exposure: any type of CHX use in the treatment or exposed group; (3) outcome: number of patients with infections; (4) comparison: placebo or other antiseptic agents; (5) English. The primary outcome was surgical site infection (SSI). RESULTS: Fourteen studies were included, with 8235 and 6901 patients in the CHX and control groups. CHX was not protective against SSI (OR = 0.77, 95% CI: 0.57-1.04, P = 0.090). CHX was protective for superficial wound infection (OR = 0.42, 95% CI: 0.26-0.70, P = 0.001), but not with deep wound infection (P = 0.509). CHX was not protective against urinary tract of infection (P = 0.415) but was protective for bloodstream infection (OR = 0.36, 95% CI: 0.16-0.80, P = 0.012), nosocomial infections (OR = 0.55, 95% CI: 0.44-0.69, P < 0.001), and pneumonia (OR = 0.26, 95% CI: 0.11-0.61, P = 0.002). CONCLUSIONS: In patients undergoing cardiac surgery, CHX does not protect against SSI, deep wound infection, and urinary tract infections but might protect against superficial SSI, bloodstream infection, nosocomial infections, and pneumonia.

Comparison of the in-vitro efficacy of different mouthwash solutions targeting SARS-CoV-2 based on the European Standard EN 14476.

The outbreak of the SARS-CoV-2 pandemic is triggering a global health emergency alert. Until vaccination becomes available, a bundle of effective preventive measures is desperately needed. Recent research is indicating the relevance of aerosols in the spread of SARS-CoV-2. Thus, in this study commercially available antiseptic mouthwashes based on the active ingredients chlorhexidine digluconate and octenidine dihydrochloride (OCT) were investigated regarding their efficacy against SARS-CoV-2 using the European Standard 14476. Based on the requirement of EN 14476 in which reduction of at least four decimal logarithms (≥4 log10) of viral titre is requested to state efficacy, the OCT-based formulation was found to be effective within a contact time of only 15 s against SARS-CoV-2. Based on this in-vitro data the OCT mouthwash thus constitutes an interesting candidate for future clinical studies to prove its effectiveness in a potential prevention of SARS-CoV-2 transmission by aerosols.

Preventing Alveolar Osteitis After Molar Extraction Using Chlorhexidine Rinse and Gel: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Alveolar osteitis (AO) may occur after molar extraction. Chlorhexidine (CHX) rinse and CHX gel are widely used to prevent AO. Although previous meta-analyses support the effectiveness of both CHX rinse and CHX gel in preventing AO, important issues regarding these two formulations have not been addressed adequately in the literature. PURPOSE: A systematic review and meta-analysis of randomized controlled trials was conducted to determine the effectiveness of CHX rinse and CHX gel in preventing AO. METHODS: PubMed, EMBASE, SCOPUS, and Cochrane databases were searched for randomized controlled trials published before June 2018. The risk ratio (RR) was used to estimate the pooled effect of AO incidence using a random-effect model. RESULTS: The RRs of AO in patients treated with 0.12% CHX rinse (RR = 0.54, 95% CI [0.41, 0.72]) and 0.2% CHX rinse (RR = 0.84, 95% CI [0.52, 1.35]) were significantly lower than in those treated with the control. Moreover, a significantly lower RR was identified in patients treated with 0.2% CHX gel (RR = 0.47, 95% CI [0.34, 0.64]) than in those treated with the control. When CHX products of different concentrations were grouped together, patients treated with CHX rinse showed an RR of AO of 0.61 (95% CI [0.48, 0.78]) and those treated with CHX gel showed an RR of AO of 0.44 (95% CI [0.43, 0.65]). On the other hand, a meta-analysis of three trials that compared CHX rinse and CHX gel directly showed a significantly lower RR of AO in patients treated with CHX rinse than in those treated with CHX gel (RR = 0.56, 95% CI [0.34, 0.96]). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results support the effectiveness of both CHX rinse and gel in reducing the risk of AO after molar extraction. Each formulation provides unique benefits in terms of ease of application and cost. On the basis of the results of this study, the authors recommend that CHX gel be used immediately after molar extraction because of the convenience and cost-effectiveness of this treatment and that CHX rinse be used by the patient after discharge at home in combination with appropriate health education and case management.

Chlorhexidine Gluconate Utilization for Infection Prevention in the NICU: A Survey of Current Practice.

BACKGROUND: Central-line-associated bloodstream infection (CLABSI) contributes to significant morbidity and mortality in the neonatal intensive care unit (NICU). Disinfection of skin is part of bundled cares aimed at prevention of CLABSI. While considered an essential component of insertion and maintenance bundles, the optimal solution to disinfect neonatal skin remains controversial. PURPOSE: The purpose of this project was to survey neonatal nurse practitioners and nursing leaders across NICUs regarding the current use of chlorhexidine gluconate (CHG) in term and preterm infants. METHODS: This descriptive study involved the collection of survey data to determine NICU practices related to the use of CHG in their infant population. The sample was composed of nursing directors of NICUs and neonatal nurse practitioners who completed an electronic survey via a provided link. FINDINGS/RESULTS: Chlorhexidine was reported to be used in 53 (82.81%) of the NICUs and was the primary agent used to prepare the skin for central vascular catheter insertion (53.23%) followed by povidone-iodine (45.16%), and 70% isopropyl alcohol (1.61%). Gestational age or birth weight restrictions for CHG use were reported in 43 (82.69%) NICUs. Trends in the data demonstrated nursing's role in using CHG in the NICU. Adverse events reported from CHG included burns, redness, dermatitis, and other irritations. Concerns included risk of absorption, burns, skin irritation, lack of evidence, and overall safety. IMPLICATIONS FOR PRACTICE: Systematic monitoring by nurse leaders is needed to identify evidence related to skin disinfection and CHG in neonates. Targeted education for nursing staff related to directed to developmental maturation of the skin, safe use of CHG, review of best evidence, rationale for usage of CHG, and potential iatrogenic effects is recommended. IMPLICATIONS FOR RESEARCH: Research is needed to evaluate the impact of educational offerings and surveillance for adverse events on CLABSI rates.

Efeito das soluções irrigadoras sobre os instrumentos Irrisafe e XP Endo utilizados na irrigação final dos canais radiculares / Effect of irrigation solutions on the Irrisafe and XP Endo used in final irrigation two root canals

Introdução: O objetivo deste estudo foi avaliar a resistência à corrosão das pontas de irrigação ultrassônica passiva Irrisafe® (Satelec/Acteon Group, Bordeaux, França) e dos instrumentos endodônticos XP Endo® (FKG Dentaire, La Chaux-de-Fonds, Switzerland), nas soluções irrigadoras hipoclorito de sódio (NaClO) 5,25%, ácido etilenodiaminotetracético (EDTA) 17% e clorexidina (CLX) 2%. O comportamento de ligas metálicas de aço inoxidável e NiTi nestas soluções também foi avaliado. Metodologia: Trinta novas pontas Irrisafe® e trinta novos instrumentos XP Endo® foram submetidos a ensaios de imersão dinâmica nas soluções irrigadoras NaClO 5,25%, EDTA 17% e CLX 2%. Cada instrumento foi submetido a dois ensaios na mesma solução com durações de 5 e 15 minutos. Antes e após cada ensaio, todos os instrumentos foram observados por microscopia eletrônica de varredura (MEV) para análise da superfície. Curvas redox das soluções de NaClO 5,25%, EDTA 17% e CLX 2% e curvas de polarização anódica de ligas metálicas de aço inoxidável e NiTi nestas soluções foram obtidas. Resultados: Não houve sinais de corrosão em nenhuma das pontas Irrisafe® e dos instrumentos XP Endo® ensaiados, independentemente do tempo de ensaio e da solução de teste utilizada. Os ensaios de polarização anódica de ambas as ligas metálicas na solução de NaClO 5,25% mostraram baixos valores de corrente até o potencial de +500 mVECS. As curvas de polarização anódica nas soluções de EDTA 17% e CLX 2% mostraram um trajeto semelhante ao da curva redox da solução em ambas as ligas metálicas. Conclusão: Concluiu-se que as pontas ultrassônicas Irrisafe® e os instrumentos endodônticos XP Endo® não sofrem corrosão nas soluções de NaClO 5,25%, EDTA 17% e CLX 2%. As ligas metálicas de aço inoxidável podem sofrer corrosão em solução de NaClO 5,25%, mas não sofrem corrosão em soluções de EDTA 17% e CLX 2%. A liga metálica de NiTi não sofre corrosão nas soluções NaClO 5,25%, EDTA 17% e CLX 2%. (AU)

Introduction: The objective of this study was to evaluate the corrosion resistance of Irrisafe® (Satelec/Acteon Group, Bordeaux, França) passive ultrasonic irrigation tips and XP Endo® (FKG Dentaire, La Chaux-de-Fonds, Switzerland) endodontic instruments in 5,25% sodium hypochlorite (NaClO), 17% EDTA and 2% chlorhexidine (CLX) irrigating solutions. The behavior of stainless steel and NiTi alloys in these solutions was also evaluated. Methodology: Thirty new Irrisafe® tips and thirty new XP Endo® instruments were submitted to dynamic immersion tests in 5,25% NaClO, 17% EDTA and 2% CLX irrigating solutions. Each instrument was submitted to two tests using the same solution for 5 and 15 minutes. Before and after each test, the surface of all instruments was analyzed by scanning electron microscopy (SEM). Redox curves of 5,25% NaClO, 17% EDTA and 2% CLX solutions and anodic polarization curves of both metal alloys in these solutions were obtained. Results: Signs of corrosion were not observed in any of the Irrisafe® tips and XP Endo® instruments tested, regardless of test time and solution used. Anodic polarization tests of both metallic alloys in 5,25% NaClO solution showed low current values to +500 mVECS potential. Anodic polarization tests of both metallic alloys in 17% EDTA and 2% CLX showed a similar path to redox curve solutions for both metallic alloys. Conclusion: It was concluded that Irrisafe® tips and XP Endo® endodontic instruments were not corroded in 5,25% NaClO, 17% EDTA and 2% CLX irrigating solutions. The stainless steel alloy suffered corrosion in 5,25% NaClO solution, but not in 17% EDTA and 2% CLX . NiTi alloy did not suffer corrosion in 5.25% NaClO, 17% EDTA and 2% CLX irrigating solutions. (AU)

[The effectiveness of hand hygiene products on MRSA colonization of health care workers by using CHROMagar MRSA]. / El Hijyen Ürünlerinin Saglik Çalisanlarinda MRSA Kolonizasyonuna Etkilerinin CHROMagar MRSA ile Arastirilmasi

The aims of this study were; to investigate the hand hygiene compliance of the health care workers (HCWs) during their routine patient care, to determine the methicillin-resistant Staphylococcus aureus (MRSA) hand colonization of the HCWs, to investigate the effect of different hand hygiene products on MRSA colonization and to evaluate the effectiveness of chromogenic agar for detecting MRSA. HCWs were investigated during their routine patient care and hand cultures were taken before and after hand wash/hygiene. Two different techniques were used to obtain the hand cultures: fingertip method (CHROMagar MRSA containing HygiSlide); and direct swab method and then inoculation to CHROMagar MRSA media. MRSA strains grown on those cultures were confirmed with conventional methods. A total of 100 HCWs (of them 61 were female; mean age: 32.7 ± 5.2 years; age range: 25-51 years) involving physicians (n= 33), nurses (n= 38) and health care assistants (n= 29), were included in the study. MRSA was detected in 39% and 11% before hand hygiene and in 13% and 6% after hand hygiene, with HygiSlide CHROMagar media and with CHROMagar in plate media, respectively. No difference were found regarding clinics, occupations, or the type of patient handling in those HCWs who were positive (n= 13) for MRSA colonization following hand hygiene, and those who were negative (n= 26). However, the type of the hand hygiene product used exhibited a statistical difference. None of the seven HCWs who used alcohol based hand rub revealed growth in the second culture while 10 of 19 (53%) HCWs who used soap and three of 13 (23%) HCWs who used chlorhexidine were still colonized with MRSA. In terms of reduction in the MRSA counts, the most effective one was the alcohol based hand rub while the soap was the least, since seven of 19 (37%) HCWs who used soap showed no reduction at all in the MRSA counts. A high ratio of hand colonization with MRSA was detected in our hospital staff (39%). It was shown that the colonization could be reduced significantly (with a rate of 66%) with hand hygiene. Alcohol based hand rub was found to be the most effective method in hand hygiene. The fingertip technique was found to be superior to inoculation to plate media for obtaining hand cultures and CHROMagar MRSA media was found to be rapid, effective and practical for detecting the MRSA hand colonization.

Systematic review and cost analysis comparing use of chlorhexidine with use of iodine for preoperative skin antisepsis to prevent surgical site infection.

OBJECTIVE: To compare use of chlorhexidine with use of iodine for preoperative skin antisepsis with respect to effectiveness in preventing surgical site infections (SSIs) and cost. METHODS: We searched the Agency for Healthcare Research and Quality website, the Cochrane Library, Medline, and EMBASE up to January 2010 for eligible studies. Included studies were systematic reviews, meta-analyses, or randomized controlled trials (RCTs) comparing preoperative skin antisepsis with chlorhexidine and with iodine and assessing for the outcomes of SSI or positive skin culture result after application. One reviewer extracted data and assessed individual study quality, quality of evidence for each outcome, and publication bias. Meta-analyses were performed using a fixed-effects model. Using results from the meta-analysis and cost data from the Hospital of the University of Pennsylvania, we developed a decision analytic cost-benefit model to compare the economic value, from the hospital perspective, of antisepsis with iodine versus antisepsis with 2 preparations of chlorhexidine (ie, 4% chlorhexidine bottle and single-use applicators of a 2% chlorhexidine gluconate [CHG] and 70% isopropyl alcohol [IPA] solution), and also performed sensitivity analyses. RESULTS: Nine RCTs with a total of 3,614 patients were included in the meta-analysis. Meta-analysis revealed that chlorhexidine antisepsis was associated with significantly fewer SSIs (adjusted risk ratio, 0.64 [95% confidence interval, [0.51-0.80]) and positive skin culture results (adjusted risk ratio, 0.44 [95% confidence interval, 0.35-0.56]) than was iodine antisepsis. In the cost-benefit model baseline scenario, switching from iodine to chlorhexidine resulted in a net cost savings of $16-$26 per surgical case and $349,904-$568,594 per year for the Hospital of the University of Pennsylvania. Sensitivity analyses showed that net cost savings persisted under most circumstances. CONCLUSIONS: Preoperative skin antisepsis with chlorhexidine is more effective than preoperative skin antisepsis with iodine for preventing SSI and results in cost savings.

The efficacy of chlorhexidine gluconate in canine skin preparation - practice survey and clinical trials.

OBJECTIVES: To determine the use in practice and efficacy of different concentrations of chlorhexidine gluconate for canine pre-operative skin preparation. METHODS: Questionnaires were used to establish which antiseptics and techniques were used for patients undergoing elective neutering. In a clinical study, five different concentrations of chlorhexidine gluconate - 0 per cent (tap water, as a control) 1, 2, 3 and 4 per cent - were tested on 50 dogs undergoing elective ovariohysterectomies and orchidectomies. RESULTS: A variety of preparation practices occurred but only 21 per cent of the veterinary nurses surveyed were aware of the concentration and contact time they used whilst preparing animals. The clinical study revealed there was a significant difference (P<0.001) between the different concentrations used. All concentrations of chlorhexidine were significantly more effective than the control tap water. There was a tendency towards increasing efficacy as concentration increased from 1 to 4 per cent but this was not statistically significant. CLINICAL SIGNIFICANCE: The lack of significant differences in efficacy between the different concentrations of chlorhexidine gluconate means that current practices may be adequate, although if the chlorhexidine gluconate concentrations and contact times used are unknown, they may be lower than those tested here and, possibly, ineffective, especially if contact times are short.

Eficácia da clorexidina em infecções endodônticas: revisão sistemática / Efficacy of chlorhexidine in endodontic infections: systematic review

Avaliou-se em estudos longitudinais a eficácia da clorexidina em infecções endodônticas detectadas por cultura ou reação em cadeia da polimerase (PCR), por meio de revisão sistemática. As estratégias de busca incluíram buscas eletrônicas (Medline, Embase, Central) e manuais, utilizando-se várias palavras-chave: chlorhexidineand (endodontic* OR endodontic* infection* OR root canal infection*). A busca apresentou 196 artigos, sendo que dos 48 estudos in vivo, sete satisfizeram os critérios de inclusão. A combinação de resultados com vistas à estruturação de uma meta-análise não foi possível em função da heterogeneidade dos estudos. O emprego da clorexidina como irrigante durante o preparo de canais radiculares infectados mostrou reduzir a microbiota endodôntica remanescente.

[Care of the non-tunneled central venous catheter. Literature search on disinfectants, dressings and intervals between dressing changes]. / Die Versorgung des nicht-getunnelten Zentralvenenkatheters. Literaturrecherche zu Desinfektionsmittel, Verbandsmaterial und Zeitpunkt des Verbandwechsels.

Patient care in hospitals often involves insertion of a non-tunneled central venous catheter for administering drugs, intravenous solutions, or total parenteral nutrition. Every change of dressing must be carried out in an appropriate fashion in order to reduce the risk of bacterial infection. We reviewed the existent literature in order to make a listof recommended disinfectants, type of dressings and intervals between dressing changes of a central venous catheter. A comparison was drawn between the guidelines of the Centers for Disease Control and Prevention (CDC) and the Robert Koch-Institut (RKI) issued in 2002 with those more recently published. Our search showed that chlorhexidine gluconate (from 0.5 to 2 percent), povidone-iodine (from 5 to 10 percent) or alcohol (70 percent) are the recommended disinfecting agents. The recommended dressing is gauze or transparent steam-permeable polyurethane dressings. Intervals between dressing changes varied between once a day and once in seven days, depending on the nature of the dressing applied.

Efecto comparativo de nuevo colutorio-gel de clorhexidina en colutorios comerciales en el crecimiento de placa en 24 horas / Comparative effect again mouthrinses-gel of chlorhexidine with commercial mouthrinses in the growth of plaque in 24 hours

Introducción. Las soluciones de clorhexidina (CHX), estándares en prevención de formación de placa presentan algunos efectos indeseados como el dolor por alcohol. Objetivos. El propósito de este estudio fue determinar la eficacia clínica de colutorio-gel acuoso de clorhexidina al 0,1% y compararla con colutorios al 0,12% y 0,1% con alcohol, evaluando el crecimiento de placa bacteriana. Materiales y métodos. En un estudio cruzado, doble ciego y randomizado, 25 alumnos de buena salud oral, participaron de cuatro estudios con abstención de limpieza oral por 24 horas, separados entre sí por 4 semanas. Los alumnos se enjuagaron por una vez con uno de los siguientes colutorios: CHX 0,12% + alcohol (Oralgene®), CHX 0,12% + alcohol (Perio.Aid®), CHX 0,1%+ alcohol (Dentilim®) y CHX 0,1% + HMC 2,5% (Colutoriogel®, acuoso nueva fórmula). Después de un día se midió formación de placa, se completó y registro el cuestionario de parámetros clínicos. Resultados. Las formulaciones de CHX 0,12% + alcohol y CHX 0,1% + HMC 2,5% se mostraron eficientes en retardar el crecimiento de placa dental de novo, esto obtenido de las mediciones clínicas, y siempre superior (p<0,05) a la formulación del colutorio de CHX 0,1%+ alcohol (Dentilim®). Conclusiones. Los resultados de este estudio demuestran el potencial clínico de este nuevo colutorio-gel sin alcohol de CHX 0,1% + HMC 2,5% (Colutoriogel®) como un efectivo agente antiplaca y con reducidas efectos secundarios registrados (AU)

The chlorhexidine solutions (CHX) standars in prevention of plaque formation present some undesired effects like the pain by alcohol. The aim of this study was to determine the clinical effectiveness of Colutoriogel® (new formulation) of chlorhexidine to the 0,1% and to compare with mouthrinses to the 0,12% and 0,1% with alcohol being evaluated growth of bacterial plaque. In double-blind, randomised, cross-over study, 25 young dental students with a healthy periodontium, abolished all means of mechanical plaque control during 4 experimental periods of 1 day (separated from each other by a washout period of 4 weeks). During each experimental period, they rinsed 1 daily with one of the following mouthrinses in a randomised order: CHX 0,12% + alcohol (Oralgene ®), CHX 0,12% + alcohol (Perio.Aid®), CHX 0,1%+ alcohol (Dentilim®) and CHX 0,1% + HMC 2,5% (Colutoriogel®). After 1 days of undisturbed plaque formation, clinical parameters were recorded and questionnaires completed. The CHX 0,12% + alcohol and the and CHX 0,1% + HMC 2,5% formulations were efficient in retarding de novo plaque formation (proven by clinical observations data), and always superior (p<0,05) to the CHX 0,1%+ alcohol (Dentilim®) solution. Conclusions. The results of this study demonstrated the potential of a new mouthrinses-gel Colutoriogel®) nonalcoholic formulation as an effective anti-plaque agent with reduced unpleasant subjective side-effects (AU)

A scanning electron microscopic evaluation of different root canal irrigation regimens.

The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM). The endodontic irrigants used were: 1% sodium hypochlorite (NaOCl); 1% NaOCl mixed to 17% EDTAC; 2% chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.

A scanning electron microscopic evaluation of different root canal irrigation regimens / Avaliação por microscopia eletrônica de varredura de diferentes regimes irrigantes no canal radicular

The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM). The endodontic irrigants used were: 1 percent sodium hypochlorite (NaOCl); 1 percent NaOCl mixed to 17 percent EDTAC; 2 percent chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.

A proposta deste estudo foi avaliar, por meio de microscopia eletrônica de varredura (MEV), a efetividade dos irrigantes endodônticos na remoção da "smear layer" das paredes dos canais radiculares instrumentados. Os irrigantes endodônticos utilizados foram: solução de hipoclorito de sódio a 1 por cento; solução de hipoclorito de sódio a 1 por cento misturado ao EDTAC a 17 por cento, gel de clorexidina a 2 por cento e gel de Ricinus communis. Fotomicrografias dos terços médio e apical foram avaliadas com o auxílio do software Fotoscore - versão 2.0. Os resultados indicaram que a mistura da solução de hipoclorito de sódio e EDTAC removeu eficientemente a "smear layer" das paredes dentinárias. Os demais irrigantes endodônticos não foram tão eficientes na limpeza dos canais.

An evaluation of preoperative skin antiseptics.

An underpinning tenet of evidence-based practice is that all routine practices should be open to scrutiny. Questioning practice should not be limited to new, experimental procedures, but should also include examination of 'tried and trusted' techniques. Taking this perspective, the author recently contributed to a systematic review evaluating the use of antiseptics preoperatively.

Avaliação clínica do efeito de Noplak(R) Max sobre gengivite e placa dental bacteriana / Clinical evaluation of the effect of Noplac(R) Max on gingivitis and dental plaque

O objetivo deste estudo foi analisar clinicamente o efeito de um enxaguatório bucal contento clorexidina (0,12%) - Noplak® Max - sobre a gengivite e placa dental bacteriana. Quarenta e cinco indivíduos apresentando gengivite moderada ou severa receberam instrução de higiene oral e foram aleatoriamente alocados em três grupos de acordo com o enxaguatório utilizado como adjunto à escovação: I) Noplac® Max; II) solução de clorexidina a 0,12%; III) placebo. Em geral, os três grupos apresentaram melhora nos parâmetros analisados, placa visível e sangramento gengival. Os pacientes do grupo II (solução de clorexidina 0,12%) apresentaram pigmentação extrínseca intensa ao final do estudo, fato este que não foi clinicamente observado nos Grupos I e III. Foi concluído que Noplak® Max é eficaz como adjunto no tratamento da gengivite, combatendo a placa bacteriana e reduzindo o sangramento gengival

Handwashing: what is the best solution?

The options for keeping hands clean in hospital include soap; antimicrobial solutions; iodine and iodophours; and alcohol solutions and rubs. Following the recent directive for alcohol rubs to be placed at hospital bedsides, this paper considers the pros and cons of these and other hand-hygiene methods.

Avaliação do efeito imediato e residual do sabão anti-séptico, do PVP-I degermante, do PVP-I tópico e da clorexidina na degermação das mãos / Evaluation of immediate and residual effect of liquid soap, degerming povidine-iodine, topic povodine-iodine and chlorhexidine on handwashing

O objetivo deste trabalho foi avaliar o efeito imediato e residual da água e do sabão bactericida, do PVP-I degermante, do PVP-I tópico e da clorexidina na degermação das mãos de graduandos da Faesa-Vitória, em procedimentos críticos. A coleta microbiológica foi realizada antes da degermação, após a degermação e uma hora após o uso de luvas. Foi possível concluir que: houve diferença significante entre o grupo água e sabão e os demais; a lavagem das mãos com água e sabão não inibiu o crescimento de Staphylococcus sp imediatamente; o PVP-I degermante e o PVP-I tópico e a clorexidina impediram o crescimento de qualquer micro-organismo no ato de seu uso e 1 hora depois