The Effect of Nose and Throat Disinfection Method with Chlorhexidine to Prevent from Nosocomial Infection after Heart Surgeries.

Background: Nosocomial infections are amongst important complications of cardiac surgical operations. The principal types of these infections appear as surgical site or respiratory infections. The rate of surgical site infections after cardiac surgery has been reported between 1 and 9 percent and the rate of respiratory infections has been up to twice this range. Various studies have attempted to make use of methods to prevent post-operative infections in addition to routine measures of preparation before surgery. Topical application of bacitracin or gentamicin ointment, intranasal mupirocin ointment, oral rinse and intranasal application of chlorhexidine solution are among these methods. The current study aimed to investigate the impact of mouth and nose disinfection with chlorhexidine solution on reduction of surgical site as well as respiratory infections after cardiac surgical operations. Methods: This study was conducted in the cardiac surgery ward, Sina Hospital, Isfahan from 1388 to 1389 as a randomized clinical trial. Patients undergoing open heart surgery entered the study. Patients were randomly assigned to two groups, whereby in one group preparation for operating room was implemented by routine methods and in the other group, mouth and nose disinfection with 0.2% chlorhexidine solution was performed every 6 hours from one day before to one day after surgery, in addition to routine hospital measures. Each patient was followed for signs of infection up to one month after surgery. Finding: From 180 patients were recruited too this study, Chlorhexidine solution was used in 88 patients and 92 other patients who comprised the control group,. The age of patients ranged from 43 to 77 years. Mean age was 61.8 years in case group and 61.5 years in control group. Total number of infections in case (intervention) group was 6 (7%) including 2 surgical site infections and 4 respiratory infections. A total of 13 patients (14%) in the control group were diagnosed with infections including 7 surgical site and 6 respiratory infections. There was no statistical difference I using chlorhexidine (P=0.232). In the case group 4 infections (66%) occurred in patients suffering from underlying diseases specially diabetes and 9 infections (69%) in the control group occurred in patients with underlying diseases. 1 patient in the control group died from acute heart failure during a second hospitalization, who also had fever and wound infection. Conclusion: Despite lower number of infections in the case (intervention) group, there was no significant difference. Some studies have attained similar results not considering nasal S. aureus carrier state. But some studies on S. aureus carrier patients have found meaningful reductions in postsurgical. [ABSTRACT FROM AUTHOR]