Surgical Incision Clinical Trial
Official title:
Does Disinfection of the Subcutaneous Tissue Reduce Contamination of the Operating Field With P. Acnes Compared to Dissection With an Electric Cautery During Primary Shoulder Surgery
Propionibacterium acnes is a pathogen commonly identified in postoperative shoulder infections. A recent study has shown that P. acnes is likely to be disseminated in the operating field from the subcutaneous layer by the manipulation of soft tissues by the surgeon and the instruments. Disinfection of the subcutaneous tissue seems to significantly reduce contamination of the operating field during primary shoulder surgery. This study seeks to assess the efficacy of disinfection of the subcutaneous tissue compared to dissection with an electrosurgical unit on P. acnes contamination during primary shoulder surgery.
The investigators are going to study the efficacy of disinfecting the subcutaneous tissue
with Betadine standard solution during primary shoulder surgery compared to electrosurgical
dissection. They will randomize 105 patients on two arms. The control group receiving no
disinfection of the subcutaneous tissue but a dissection with an electric cautery(A) and
intervention group receiving a disinfection of the subcutaneous tissue (B). They believe that
the duration of 4 years is sufficient to recruit the number of patients necessary for this
study.
All patients 18 years of age or older admitted to Valais Hospital for primary shoulder
surgery and having signed the consent of the study will be eligible.
The use of disinfection of the subcutaneous tissue during primary shoulder surgery could
reduce contamination of the operating field and theoretically the post-operative infection
rate after primary shoulder surgery.
The study focuses on disinfection with Betadine solution of the subcutaneous tissue during
primary shoulder surgery. This action could decrease contamination of the operating field and
the infection rate after primary shoulder surgery.
This solution is already widely used for disinfecting the skin and traumatic or surgical
wounds.
The investigators will use it according to the recommendations made in the Swiss Compendium
of Medicines.
No evidence has been brought to a decrease in this contamination if the dissection is carried
out with an electric cautery. Scalpel dissection is used as standard in orthopedic surgery as
well as in other surgical disciplines.
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