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Reducing HCAIs
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TOPIC: Pre-operative Whole Body Disinfection Guidelines

Pre-operative Whole Body Disinfection Guidelines 1 year, 1 month ago #1

I am looking to do some research for my MSc into patients Whole Body Washing with an antiseptic before they go into hospital for surgery to ultimately reduce the chance of SSI’s. I have heard many people advocate antiseptic products whereas others just let their patients follow their normal practice including no washing at all.

However I have been looking at the NICE guidelines and they say there is not enough evidence to say that using an antiseptic is any better at reducing SSI’s than not doing whole body washing at all. Surely this cannot be the case because if there was at least a chance of helping the patient by eradicating one potential source of SSI, then it should be taken, right?

Can any of the healthcare professionals on this site help me with their opinion as to why the CDC would strongly recommend washing with an antiseptic, whereas NICE wouldn’t advocate anything at all?
Last Edit: 1 year, 1 month ago by Scott Buckler.

Re: Pre-operative Whole Body Disinfection Guidelines 1 year ago #2

med-nexus.co.uk/index.php?docid=13&d...+Total+Body+Washing+

Hayley,
The above link might be useful. If the full link doesn't work just go to www.med-nexus.co.uk and click on TBW. This page remains unfinished but was going to be my case to put to my Trust for TBW.

In my view Cochrane and NICE both have limitations in how they look at data. (If the topic interests you I can put you in touch with Prof. Richard White who edits Wounds UK. He campaigns on the issue of evidence and how it is assessed).
Essentially any meta-analysis will be looking at old data in heterogenous patient groups.

It is interesting that the Swedish government has completely ignored the Cochrane review. That tells you something.

I am plastic surgeon doing mainly skin cancer. An audit of my groin dissection patients showed an unacceptably high wound infection rate. I adopted a SSI care bundle that included TBW. Groins are highly contaminated and it is very likely that any analysis of TBW in these patients would yield very different results from big studies that look at a wide variety of surgical procedures where the SSI rates are very small.

Without being too philosophical there are serious deficiencies in the way gather and analyse data across the board in IPC.

BW
Graeme Moir 

Re: Pre-operative Whole Body Disinfection Guidelines 1 year ago #3

Wow, thanks Graeme,
That site is really interesting and I would love to get in contact with Prof White as to getting his opinion on the subject too, but I am all too aware of how much literature reading I need to carry out before I approach anybody credible at this stage so as not to sound like a bumbling idiot ;-)
I work for a Swedish company and although I would like to keep my project as open as possible with regard to which antiseptics to advocate, I was speaking to some swedish nurses at the IFIC conference last year who were telling me of their education programmes so I would like to look into that also, even though the NHS and the UK are both close to my heart.
If anybody else on these forums also have any opinions (either positive or negative) on this subject , I would be interested in getting your views too.
Thanks
Hayley x

Re: Pre-operative Whole Body Disinfection Guidelines 1 year ago #4

Hi Graeme

I have just looked at your site again and would like to let you know that the most recent Denton reference was written in the 2001 version of Seymour Block's: Disinfection, Preservation and Sterilization. (I know this as i have just been trying to locate in vitro and in vivo evidence for chlorhexidine as part of my job role and use a few of the MIC data he quotes).

Also there is now a recent publication of J Tanners work on whole body washing from Issue 1 of Journal of Infection Prevention: A Fresh look at preoperative body washing (this was one of my starting papers for this project of mine!)

Your website is very informative and strangely of similar objectives to one of mine in my MSc project. I would love to discuss it further with you and Professor White if you are at the HCAI conference or by email beforehand if you would prefer?

Thank you again for your reply, I originaly thought this subject would provoke some conversation on here but it seems I was wrong.

Hayley x

Re: Pre-operative Whole Body Disinfection Guidelines 11 months, 2 weeks ago #5

Hayley,
Sorry not to respond sooner but I have been locked out of the GovToday forum. I got on just now using a colleague's login details.

Would be happy to put you in touch with Richard White. My email is This email address is being protected from spambots. You need JavaScript enabled to view it.

I missed much of the meeting because I intended to catch up when they posted the post event videos and slideshows and was going to be active on the forum. However it became too much effort when the site locked me out.
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