PURPOSE Chlorhexidine showers prior to shoulder arthroplasty are commonly recommended by surgeons to lower the risk of periprosthetic infection; however, the effectiveness of these washes in eliminating bacteria from the skin of the shoulder has not been thoroughly evaluated. The objective of this study was to determine the degree to which pre-operative chlorhexidine washes effectively eliminate bacteria from the epidermal skin surface and from the dermis freshly incised during shoulder arthroplasty. METHODS Around 66 patients undergoing primary shoulder arthroplasty were instructed to shower with chlorhexidine before surgery. Each patient had three skin swabs: (1) the epidermis at a pre-operative clinic appointment, (2) the epidermis at surgery after home chlorhexidine showers but prior to skin preparation, and (3) the dermis after incision of the prepared skin. The bacterial loads of Cutibacterium and other bacterial types from each swab were compared to determine whether the showers were effective in altering the bacterial loads. RESULTS Chlorhexidine washes were effective in reducing the skin load of other bacterial species (p < 0.005), but they did not decrease the skin load of Cutibacterium (p = 0.585). CONCLUSIONS Pre-operative skin showers with chlorhexidine were not effective in reducing the load of Cutibacterium on the skin of patients having shoulder arthroplasty. Since Cutibacterium is responsible for the highest percentage of shoulder periprosthetic infections, research is needed to identify more effective means of removing these bacteria from the surgical field.

中文翻译：

---

虽然肩部手术前家用洗必泰清洗可以降低大多数细菌的皮肤负荷，但它们对皮肤杆菌（丙酸杆菌）无效。


目的 外科医生通常建议在肩关节置换术前进行洗必泰淋浴，以降低假体周围感染的风险；然而，这些清洗方法在消除肩部皮肤细菌方面的效果尚未得到彻底评估。本研究的目的是确定术前洗必泰清洗有效消除表皮皮肤表面和肩关节置换术期间新鲜切开的真皮中细菌的程度。方法 大约 66 名接受初次肩关节置换术的患者被要求在术前使用洗必泰淋浴。每个患者都有三个皮肤拭子：(1) 术前门诊预约时的表皮，(2) 家庭洗必泰淋浴后但备皮前手术时的表皮，以及 (3) 切开准备好的皮肤后的真皮。对每个拭子中的皮肤杆菌和其他细菌类型的细菌含量进行比较，以确定淋浴是否能有效改变细菌含量。结果 洗必太洗液可有效减少其他细菌种类的皮肤负荷（p < 0.005），但不会减少皮肤杆菌的皮肤负荷（p = 0.585）。结论 术前用洗必太进行皮肤淋浴不能有效减少肩关节置换术患者皮肤上的皮肤杆菌负荷。由于皮肤杆菌是造成肩假体周围感染比例最高的原因，因此需要进行研究来找出更有效的方法，将这些细菌从手术区域去除。