Effect of chlorhexidine pretreatment on bacterial contamination at rhinoplasty field

BACKGROUND: This study investigated on bacterial contamination of the rhinoplasty field. The effect of preoperative chlorhexidine treatment on decreasing bacterial contamination in the rhinoplasty field is examined. METHODS: Thirty patients who underwent rhinoplasty were block randomized into a chlorhexidine, regular-soap, or control group comprising ten participants each. The chlorhexidine group was subjected to chlorhexidine showering, shampooing, and facial-cleansing 12 h prior to the operation. The regular-soap group was subjected to cleansing with regular soap, and the control group did not have any skin pretreatment. Bacterial cultures were done 12 h preoperatively from nasal cavity and perinasal skin, immediately preoperatively from perinasal skin and at 1 and 2 h intraoperatively from operation field. Culture results were compared between the three groups, according to operation time, or whether infection-prone procedure was performed. RESULTS: The bacterial species and colony-forming unit numbers at preoperative nasal cavity and perinasal skin were similar. In all three groups, Coagulase-negative staphylococcus was the most common bacteria found in the rhinoplasty field. The numbers of Staphylococcus aureus and Corynebacterium decreased rapidly after preoperative chlorhexidine treatment. The infection-prone procedure was associated with increased bacterial numbers over time during the operation. In all three groups, there was no postoperative infection in a follow-up period of 6 months. CONCLUSION: Rhinoplasty is confirmed as a clean contaminated operation with skin flora consistently found in the operation field. Chlorhexidine pretreatment in rhinoplasty patients has a tendency to decrease the numbers of Staphylococcus aureus and Corynebacterium on the perinasal skin. LEVEL OF EVIDENCE: Randomized controlled trial, Level I.