Daily Cosmetic Research Analysis

BACKGROUND CONTEXT: Surgical site infections (SSIs) are a significant complication in spine surgery, particularly in instrumented procedures, leading to increased morbidity and healthcare costs. Despite standard preoperative disinfection protocols, bacterial contamination remains prevalent. Strategies such as intraoperative antiseptic irrigation have been explored to mitigate contamination, yet the comparative efficacy of different antiseptic solutions remains unclear. PURPOSE: This study aimed to evaluate the effectiveness of intraoperative antiseptic solution soaking with normal saline (NS), povidone-iodine (PVP-I), and chlorhexidine gluconate (CHG) in reducing bacterial contamination in lumbar instrumented fusion surgery. STUDY DESIGN/SETTING: A single-center, single-blinded, randomized controlled trial was conducted at a tertiary medical center in Taiwan. PATIENT SAMPLE: A total of 105 patients undergoing posterior lumbar interbody fusion surgery were enrolled and randomly assigned to three groups: NS (n=35), PVP-I (n=35), or CHG (n=35). Patients with prior lumbar procedures, known allergies to antiseptics, previous spinal infections, trauma, or tumors were excluded. OUTCOME MEASURES: The primary outcome was the reduction in bacterial contamination, assessed via intraoperative cultures from three sites-superficial tissues, deep tissues, and implant surfaces-before and after antiseptic irrigation. Secondary outcomes included the incidence of postoperative SSIs and clinical complications over a 6-month follow-up period. METHODS: Patients were randomized into three groups, each receiving a 3-minute soak with the assigned antiseptic solution before wound closure, followed by normal saline irrigation. Swab samples were collected pre- and postirrigation for bacterial culture and 16S rRNA PCR analysis. Statistical analysis was performed using logistic regression and Bonferroni correction for multiple comparisons. RESULTS: Among 105 patients, preirrigation bacterial culture positivity rates were 49.5% in superficial tissues, 31.4% in deep tissues, and 32.4% on implants. Postirrigation, NS showed no significant bacterial reduction, while PVP-I reduced superficial contamination (55.0%, p=.015) but no significant effect in deeper tissues and implants. CHG showed the greatest bacterial reduction, significantly outperforming NS (OR: 0.06, 95% CI: 0.01-0.54, p=.011) and PVP-I (OR: 0.06, 95% CI: 0.01-0.56, p=.012) on implant surfaces. Despite these differences in culture rate, SSI rates remained low and comparable among groups (p=.72), with no reported antiseptic-related complications. CONCLUSION: This study confirms that bacterial contamination remains high despite standard preoperative disinfection in lumbar fusion surgery. Among the tested antiseptic solutions, CHG demonstrated superior efficacy in reducing bacterial residues, particularly on implant surfaces. These findings support CHG as a promising antiseptic for intraoperative irrigation in spine surgery. Further multicenter studies are needed to validate its impact on reducing SSIs and improving long-term outcomes. LEVEL OF EVIDENCE: Level II.

BACKGROUND: Antibacterial ingredients for oral care products are typically measured through single product forms. This study assessed the overall health outcome of using multiple forms: a stabilized stannous fluoride toothpaste, an enhanced cetylpyridinium chloride mouthwash and a unique toothbrush to deliver antibacterial performance. METHODS: A 12-week, single-center, phase III, masked, 2-arm, parallel-group, randomized controlled trial was conducted to assess the reduction of established dental plaque and gingivitis with a novel antibacterial oral regimen comprised of 0.454% stannous fluoride toothpaste stabilized with nitrate and phosphates, 0.075% cetylpyridinium chloride and 0.28% zinc lactate mouthwash, and rapid foaming manual toothbrush compared to a nonantibacterial commercially available regimen of toothpaste containing 0.76% sodium monofluorophosphate, no mouthwash, and commercially available manual toothbrush to represent standard toothbrushing practices. RESULTS: Adherence to this novel oral care regimen provided significant reduction in plaque and gingivitis compared to the control starting at 1 week (P < .01) and continuing over 12 weeks (P < .001) across all plaque and gingival score indices. At week 1, participants in the Antibacterial Regimen Group showed 15 times more plaque reduction than control (P < .001). After 3 weeks of regimen adherence, 100% of Antibacterial Regimen participants had improved gingival index scores compared to baseline. CONCLUSIONS: Within the limitations of the study, the results showed statistically significantly reduced gingival inflammation and improved plaque control from 1 week continuing through 12 weeks of adherence to this novel oral care regimen compared to standard toothbrushing practices.

Subcuticular sutures, which are effective and cosmetically advantageous in gastroenterological surgery, are time-consuming and heavily dependent on the surgeon's technical expertise. This study aims to evaluate whether Zipline skin closure could be an alternative to subcuticular sutures in gastroenterological surgery. A multicenter randomized controlled trial (UMIN000048169) was conducted on 76 patients who underwent elective gastroenterological surgery. The patients were randomized to either the Zipline group (N = 35) or the subcuticular suture group (N = 41). Primary outcomes included skin closure time and secondary outcomes included postoperative wound complications and cosmetic results, assessed 6 months post-surgery, using the Stony Book Scar Evaluation Scale (SBSES). The Zipline group demonstrated significantly shorter closure times than the suture group (median: 438 s [406-526] vs. 575 s [537-638]; p = 0.003). This difference was more pronounced for incisions > 55 mm (median:399 s [307-533] vs. 605 s [493-736]; p = 0.001). No significant differences were observed in wound infection rates (5.7% vs. 2.4%; p = 0.46) or SBSES scores (median: 4.0 [4.0-5.0] vs. 4.0 [3.0-5.0; p = 0.82) between the two groups. The Zipline device reduced the skin closure time in gastroenterological surgery significantly, particularly for large incisions, without compromising wound healing or cosmetic outcomes. These findings suggest that the Zipline system may be a viable alternative to traditional subcuticular sutures in gastroenterological procedures, potentially promoting operating room efficiency without compromising surgical quality or patient outcomes.