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Health Care Industry
Industry: Email Alert RSS FeedPreoperative skin preparation of cardiac patients
AORN Journal, Nov, 2002 by Cynthia G. Segal, Jacqueline J. Anderson
Table 1
DATA COLLECTION SHEET
Inclusion factors
1. Any patient undergoing coronary artery bypass graft (ie, first
procedure or redo, not a combined valve procedure)
2. Patient must have one or more of the predictive factors from the
sternal wound model to participate in this initiative (see below)
Sternal wound model
1. Type 1 diabetes yes/no list medications
2. Type 2 diabetes yes/no list medications
3. Chronic obstructive
pulmonary disease yes/no list medications
4. Weight > 120% of ideal
weight (see precalculated chart *) yes/no
Height (cm) 147 150 152 155 157 160 163 165 168 170 173 175 178 180
Males (kg) 55 57 60 63 66 68 71 74 77 79 82 85 88 90
Females (kg) 49 52 55 57 60 63 66 68 71 74 77 79 82 85
Height (cm) 183 185 188 190 193
Males (kg) 93 96 98 101 104
Females (kg) 88 90 93 96 98
Exclusion factors (if the patient meets any of these criteria,
he or she is not eligible to participate)
1. Preexisting infection (eg, elevated white blood cells or
temperature > 100.5[degrees]F [38.06[degrees]C])
2. Allergy to topical iodine
3. Emergency, cardiopulmonary resuscitation in progress
Prep groups (please circle which group the patient was randomized to)
1. Povidone-iodine paint
2. Povidone-iodine five-minute scrub with paint
3. One-step iodophor/alcohol water insoluble film
4. One-step iodophor/alcohol water insoluble film with iodine
impregnated incise drape
Patient demographics
1. Age --
2. Height -- cm
3. Weight -- kg
4. Sex male/female
5. Preoperative glucose --
6. History of hypertension yes/no
7. History of smoking yes/no
8. History of renal disease yes/no
9. History of peripheral vascular disease yes/no
10. History of myocardial infarction yes/no
11. Preoperative antibiotics yes/no
12. Preoperative intubation yes/no
13. Preoperative pressors yes/no
OR experience
1. Redo yes/no
2. Ejection fraction percentage --
3. Internal mammary artery yes/no/bilateral
4. Time in OR --
5. Time out OR -- total OR time --
6. Total time on bypass --
7. Total cross clamp time --
8. Coolest temperature on pump -- out of OR --
9. Red blood cell count --
Plasma count --
Platelet count --
10. Intra-arterial blood pressure --
Chest open yes/no
11. Last OR glucose
12. Postoperative pressors
* Locate the patient's height on the chart. If the patient weighs more
than the corresponding weight, he or she is considered obese. For
example, a 160-cm female who weighs 68 kg would be considered obese.
Table 2
PATIENTS DEMOGRAPHICS
Mean age--60.9 years
Mean total OR time--248 minutes [+ or -] 60
Mean pump time--72 minutes [+ or -] 29
Mean cross clamp time--42 minutes [+ or -] 20
Last OR glucose--434 [+ or -] 210
Table 3
COMPARISON OF SKIN PREP GROUPS
Prep group Infected Not infected Total
Povidone-iodine paint 7 49 56
Povidone-iodine five-minute 7 45 52
scrub with paint
One-step iodophor/alcohol 1 49 50
water insoluble film
One-step iodophor/ 3 48 51
alcohol water insoluble
film with iodine
impregnated incise drape
Total 18 191 209
[chi square] = 5.889, P = .117
Table 4
COMPARISON OF AQUEOUS
AND INSOLUBLE PREPS
Prep group Infected Not infected Total
Aqueous iodine 14 94 108
Insoluble iodine 4 97 101
Total 18 191 209
[chi square] = 5.3, P = .02
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