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Preoperative Patient Preparation in Small Animal Veterinary Medicine: A Review of Antiseptics, Investigation of Effectiveness, and Novel Method for Effectiveness Testing
Abstract
This review describes commonly used antiseptics in veterinary medicine including their mechanism of action, spectrum of activity, potential adverse effects, and application techniques. Additionally, it includes a literature review of small animal antiseptic studies, discussion of effectiveness versus efficacy studies, and the potential for increased resistance to antimicrobials. We conclude that continued research is needed to fill gaps in the current knowledge such as optimal preparation procedures for various surgical sites, standardization of efficacy and effectiveness testing, and the clinical impact of decreased susceptibility to chlorhexidine and other antiseptics.
To add to the current literature, a prospective, multi-institution investigation to evaluate the effectiveness and safety of two common antiseptic solutions, chlorhexidine and povidone-iodine, in the initial preparation of the external ear prior to ear surgery on dogs was performed. Both antiseptic groups showed a significant reduction in bacterial growth score (BGS) between pre- and post- antiseptic use. There was no difference in reduction of BGS between both solutions. Minor adverse skin reactions occurred in 25% of cases; there was no significant difference in the occurrence of adverse skin reactions between antiseptics. In conclusion, properly diluted aqueous formulations of either antiseptic may be used for safe preparation limited to the external ear canal of dogs.
To address potential limitations of bacterial culture in effectiveness testing, a prospective clinical study was performed to evaluate the ability of a novel method of viable bacterial quantification, viability PCR (PMA-PCR), to quantify a reduction in bacterial load after antiseptic use in low- and high- bacterial load environments, as well as to compare PMA-PCR findings to qPCR and semi-quantitative bacterial culture. All methods found a significant decrease in bacterial load on oral mucosa after antiseptic preparation. PMA-PCR had a significantly greater reduction in bacterial load after preparation than qPCR. Only culture detected a significant reduction after preparation of the skin. In conclusion, the results of this study support continued use of culture in evaluations of antiseptic effectiveness in clinical dog patients, given its ability to detect a change in bacterial load after antiseptic preparation of sites with both high and low bacterial load.
Citation
Nye, Alicia Kaye (2022). Preoperative Patient Preparation in Small Animal Veterinary Medicine: A Review of Antiseptics, Investigation of Effectiveness, and Novel Method for Effectiveness Testing. Master's thesis, Texas A&M University. Available electronically from https : / /hdl .handle .net /1969 .1 /198573.