Tuesday, September 9, 2014

Surgical skin preparation does not eliminate Propionibacterium from the skin

Propionibacterium Persists in the Skin Despite Standard Surgical Preparation

It is understood that Propionibacterium can persist on the skin surface after surgical preparation.
This study from our team at the University of Washington, recognized that Propionibacterium normally reside in the dermal layer which must be transected in surgery. The authors sought to determine the prevalence of propionibacteria in the dermis after surgical skin preparation. 

Ten healthy male volunteers underwent surgical skin preparation of the upper back with ChloraPrep. Two 3-mm dermal punch biopsy specimens were obtained through the prepared skin and specifically cultured for Propionibacterium.
Seven of the ten subjects (70%) had positive dermal cultures for Propionibacterium on dermal cultures in spite of ChloraPrep skin preparation. The average time for the cultures to turn positive was 6.8 days.

CommentPropionibacterium are commonly associated with failure of shoulder arthroplasty, usually presenting with pain, stiffness and implant loosening.  This study demonstrates that standard skin preparation does not remove viable Propionibacterium from their location in the skin. Surgical transection of the dermal hair follicles and sebaceous glands where Propionibacterium reside can result in contamination of the surgical wound and to the formation of a persistent biofilm on implanted arthroplasty components.


Check out the new Shoulder Arthritis Book - click here.

To see the topics covered in this Blog, click here

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'