Surgical site infections (SSIs) are a common and costly complication of surgery. They increase healthcare expenditures, prolong patient recovery, and contribute to the global problem of antibiotic resistance. Even a simple SSI can extend a patient’s hospital stay by 7-10 days.
Causes of SSIs
SSIs primarily stem from two sources:
- Endogenous flora: This is the primary source and comprises microorganisms that normally reside on the patient’s body. These typically inhabit the skin, mucous membranes, or hollow organs.
- Exogenous flora: These are microorganisms from the environment that contaminate the surgical site during the procedure. Sources include the operating room, contaminated instruments, or contact during postoperative care.
Pathogens typically invade the surgical site directly during the operation. These primarily originate from the skin incision area, surrounding tissues, or the external environment. Transmission occurs through direct and indirect contact, particularly via the surgical team’s hands.
Preventing SSIs: Best Practices
Surgeons play a critical role in minimizing SSIs. Key preventative measures include:
- Hand hygiene: Thoroughly clean hands and forearms up to the elbows with an antiseptic agent immediately before surgery.
- Skin preparation: Meticulously disinfect the surgical site with an appropriate antiseptic solution.
- Sterilization: Ensure proper sterilization of instruments and the operating room environment.
- Barrier precautions: Wear surgical masks, gowns, and gloves according to established protocols.
- Antibiotic prophylaxis: Administer prophylactic antibiotics within 60 minutes before the incision and discontinue within 24 hours after surgery.
Adhering to infection prevention guidelines established by the Ministry of Health and utilizing appropriate antiseptic solutions are crucial for preventing and minimizing SSIs.
Selecting an Effective Antiseptic Solution
Several antiseptic agents are commonly used for skin preparation, including isopropyl alcohol, povidone-iodine, chlorhexidine, and HOCl. Each has its own set of advantages and disadvantages:
- Isopropyl alcohol: Cost-effective but can cause irritation and is flammable.
- Povidone-iodine: Offers rapid action but can stain the skin, cause stinging, and potentially delay wound healing.
- Chlorhexidine: Provides prolonged action but can be cytotoxic and may cause irritation and burning sensations.
- HOCl: Exhibits non-selective, rapid killing of a broad range of microorganisms, including bacteria, viruses, fungi, yeasts, and spores, while being safe for human tissue and the environment.
Hypochlorous acid (HOCl) is naturally produced by neutrophils as part of the innate immune system. It is well-tolerated and highly effective in reducing bacterial burden, thereby minimizing infection risk. Studies have demonstrated HOCl’s efficacy against a wide array of pathogens, including Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, various fungi (Table 1), and biofilms.
Studies evaluating HOCl as a surgical antiseptic have demonstrated rapid and significant reductions in bacterial load. Within 30 seconds of application, resident bacterial populations decreased by 3.44 log10 in the inguinal region and 1.86 log10 in the abdominal region (BioScience Laboratories Report # 050811-103). Furthermore, in vitro research indicates that HOCl exhibits no cytotoxic effects on fibroblasts and does not impede wound healing.
Importantly, as Rubinsky et al. (2016) noted, bacteria cannot inactivate HOCl, rendering resistance development unlikely. This makes HOCl a particularly attractive option for wound and surgical site antisepsis in the face of growing concerns about antibiotic resistance.
MiraChlor: A Superior HOCl Solution
Letus’s MiraChlor product boasts a 99.99999% kill rate against pathogens within a mere 15 seconds, all while remaining safe for both the patient and the environment. It fulfills the criteria for an ideal antiseptic/disinfectant:
- Broad-spectrum activity: Effective against both Gram-positive and Gram-negative bacteria, as well as fungi.
- Rapid and potent antimicrobial action: Swiftly eliminates a wide range of microorganisms.
- Anti-inflammatory properties: Reduces inflammation and disrupts biofilms, which hinder bacterial eradication and wound healing.
- Promotes natural healing: Facilitates efficient and natural healing of skin lesions.
- No resistance development: Microorganisms are unable to develop resistance to HOCl.
- Safe and well-tolerated: Non-irritating, with no adverse effects, enabling long-term use.
- Free of harmful substances: Does not contain any toxic or harmful ingredients.
MiraChlor antiseptic for medical use
. Disinfect before, during, and after surgery
. Disinfect wounds, ulcers, and surgical incisions
Supporting Evidence:
- Ministry of Health Guidelines: Aligns with the Ministry of Health’s guidelines for surgical site infection prevention (Decision No. 3671/QD-BYT dated September 27, 2012).
- Clinical Research: Studies, such as “Use of Hypochlorous Acid as a Preoperative Antiseptic Before Placement of Dermal Fillers” (Chapman et al., 2008), support the efficacy of hypochlorous acid (the active ingredient in MiraChlor) as a preoperative antiseptic.
- Cho Ray Hospital Best Practices: Conforms to the best practices for SSI prevention employed by Cho Ray Hospital.