Science. Applied to Life.” gainst Micrel‘, —Contamination _ Surgical Skin Antiseptics and _ Antimicrobial Incise DrapesStart with the proper prep ‘A proper skin prep reduces a patient's bacterial load throughout the perioperative process, providing both immediate and lasting protection. But not all preps perform the same during surgery. Preps need to stay on the skin to remain effective. Preps can be removed during surgery by saline irrigation, dabbing with sponges or gauze, or contact with bodily fluids. SURGICAL CHALLENGES TO PREPS Irrigation Wiping Dabbing Bodily fluids Manipulation = G@ J OC P moved during surgery, patients ive ingredient. Resisting removal during surgery 3M™ DuraPrep™ Surgical Solution (Iodine Povacrylex [0.7% available iodine] and Isopropyl Alcohol, 74% w/w) Patient Preoperative Skin Preparation was scientifically formulated to protect the prep from removal during surgery. It contains 3M™ Prep Protection Film, which" 344 Prep dries to form a persistent and durable layer of protection on the patient's skin. Protection Asa result, a study showed that 3M DuraPrep surgical solution is more resistant to removal Film by saline-soaked gauze than ChloraPrep™ Skin Prep. In fact, the same study showed that 3M. YY DuraPrep surgical solution had significantly greater bacterial reduction than ChloraPrep™ Skin Prep after challenge by saline-soaked gauze in simulated surgery.” SKIN SKIN 3M™ DuraPrep™ Surgical Solution ChloraPrep™ Skin Prep 7 *Forilustrative purposes only: not meant to represent spectcresuits. See study for detaReducing incise drape lift Incise drape lift at the edge of an incision can allow bacteria to migrate into the surgical wound. In fact, in one study drape lift was associated with a six-fold increase in SSI? Some skin preps, such as ChloraPrep” Skin Prep, can lead to increased drape lift. The 3M Prep Protection Film in 3M DuraPrep surgical solution acts as a primer that helps a drape stick to the patient's skin to protect against incise drape lift. = fe] fe] . ssi% Help lower the risk of infection (GhloraPrep™ 8.2 Skin Prep In a sequential implementation study on the effect of preoperative preps on infection rate, it was observed that surgeries using lodophor-based a8 iodophor-based surgical preps (including ‘surgical preps o p= 001 DuraPrep surgical solution) had a significantly lower SSI rate than surgeries using ChloraPrep™ ‘SSI rate by prep received, ‘Skin Prep. N=3,209 general surgeriesPreps alone are not enough ‘While skin prep antiseptics reduce microbes, they work primarily on the skin surface, not in the deeper layers of the skin. Chlorhexidine gluconate (CHG), in skin preps, for example, does not penetrate into the deeper layers of the skin. Below a depth of 300 microns, CHG concentration may not be effective for kiling bacteria.® Without additional protection, residual bacteria on the skin’s surface and bacteria that migrate from the hair follicles can be picked up by items that touch the skin and transferred into the incision, increasing the patient's risk of infection. Skin preps é -_ 7 * work here... e i 7 ° em - WwW = - - - = ° i a - -@ - @- = © —” 300ym= --° Skin preps are antimicrobial and reduce the number of microbes on the skin surface, but bacteria in the deeper layers may remain.Use an incise drape An incise drape creates a physical barrier to prevent objects like instruments, gloves and sponges from coming into contact with the patient's skin, reducing the risk of contamination that could cause a costly and potentially devastating SSI. In a recent ex vivo study on human skin, the iodine in 3M™ loban" 2 Antimicrobial Incise Drape was shown to be present at concentrations effective against MRSA at a depth of 1,000 microns, in the deeper layers of the skin, where hair follicles are present’ 3M™ loban™ 2 Antimicrobial Incise Drape creates a sterile barrier, and e from the drape has been shown to be present in the deeper skin layers.” J ee fe ot re é ind 1000pmHelp lower SSI risk and costs Bejko study results® In a study published in 2015, 3M™ loban™ 2 Antimicrobial Incise Drape ‘was associated with lower SSI risk and reduced cost when compared to a non-antimicrobial incise drape in cardiac surgery. Neworospecine randonized study of iSSirateleedustion’of 7176) patients undergoing cardiac surgery. At 6.5%, overall incidence of Les rmereer rete SSls for patients who received aananet Van mee oe Tes ate Sete 2 a non-antimicrobial incise drape ‘Antimicrcbsl cise Drope. Examined the was significantly higher than ee aes the 1.9% of those who received almiorie 3M™ loban™ 2 Antimicrobial Incise Drapes (p=0.001). ee en SOLE TSAR ‘of VAC + hourly cost of the operating total cost savings or ome wound eden + daily cost about $1,025 per patient with 3M loban 2 incise drapes.Reduce wound infection rates % surgical site infection rate Yoshimura study results® Ina retrospective study involving uae ; Se 121% liver resection surgery, 3M loban cd 2 incise drape, compared with no incise drape, was associated with a significant reduction in 3M™ lobari™ postoperative wound infection eee bial ‘Seite rates, from 12.1% to 3.1% (p=0.01)._—Incise Drape wet from 1994 to 2001 looking at 296 patients undergoing Examined tha impact on wound fection using just a kn prep ‘ua skin prop end 3M loten 2 lncise Drapes. Using a sterile surface to fight SSIs The tisk of SSI is a real — and devastating — possibility for every surgical patient. Using an effective prep along with an antimicrobial incise drape reduces bacterial load and creates a sterile surface to minimize wound contamination.Sterile Surfa INCISE ‘Drapes 3M™ loban™ 2 Antimicrobial Incise Drapes Because skin cannot be sterilized, the use of an incise drape helps reduce the risk of wound contamination.Only a drape does what a drape does. ‘Skin surface that has been prepped has. only been disinfected, not sterilized. Patient Pre-operative preps are not enough. You need a drape. By definition, a skin surface covered by a sterile incise drape creates a sterile barrier atthe beginning of surgery, whereas a skin surface that has been repped has only been disinfected, not sterilized. ‘Skin preps cannot completely eradicate bacteria ‘Skin preps are vulnerable to removal or neutralization during surgery by blood, exudate and irigation fluids * Bacterial regeneration occurs continuously on the skin even after prepping Epidermal Cells => Incise Drape Prep + Fig. 15 - Incise Drape/Bacterial Regeneration Stops at the Incise Drape/Bacterial Regeneration Emerges to the Skin's Surface 20Drape lift has been associated with a six-fold increase in surgical site infection.’ A drape’s barrier is only effective when the drape is securely adhered to the patient's skin all the way to the incision site. Drape Adhesion with 3M™ DuraPrep"™ Surgical Solution acne Povacryex (0.7% avalabe ade] and opp ‘ato 1m) Pt Prnprathe Sin Prpmaon Ws ChioraPrep® Patient Preoperative Skin Preparation colthendne Goat (CHE) 470% pop Adel (PA) at T=30 Minutes Under Wet Conditions® Hh oro stm ows 1. Alexander, JW, Aern, S., and Plettner, JP. 1985, Development of a Safe and Effective ‘One-Minute Precperative Skin Preparation. Arch Surg. 120: 1357-1361 2. Data on file i2MS Study-05-010515 (2006), 3M Health Care aiWhat separates one incise drape from all the rest is where its antimicrobial agent lives. The antimicrobial in 3M" loban™ 2 loban 2 Antimicrobial Drape antimicrobial incise drapes is in the adhesive — so it’s in constant contact with the skin. loban 2 antimicrobial incise drapes are made from a polymeric film coated with a pressure-sensitive adhesive. An iodophor complex is incorporated into the adhesive and provides antimicrobial properties (Fig. 17). loban 2 antimicrobial incise drapes not only immobilize bacteria, their iodophor complex ‘continues to come in contact with a patient’s skin. In an in vitro study, loban has been demonstrated to be effective in reducing microorganisms." Other Clear incise drapes simply immobilize bacteria, but ‘do not contain an antimicrobial agent. 1. Eyberg, CE., MS, Morse, .J., MS, Olson, LK., BS, and Parks, PJ, MD, PhD. 2008. An in vitro Time-kil Study ‘to Compare the Antimicrobial Activity of Three Antimicrobial Surgical Incise Drapes. 19th Annual Scientific Meeting ‘ofthe Society for Healthcare Epidemiology of America (SHEA), March 19-22, 2009, San Diogo, California.Not all antimicrobial incise drapes are created equal. Test methods that directly apply the drape Conclusions: to the skin and measure skin flora are very dayne difficult to correlate with real suppression at SM" lohan 2 Aninicrabia inci Drapes Were the skin surface. Buta time-kill study clearly significantly better at reducing the microbial counts reveals the difference between drapes. when compared with ISO Drape® Incise Drape alison Ga . The objective ofthe audy wes to measure the ‘featuring Microban® Antimicrobial Protection and MCD ACTI-Gard® for all microorganisms tested at antimicrobial activity of three different antimicrobial 90 minutes. incise drapes, using an in vitro time-kill method. A3M™ Steri-Drape™ Incise Drape, with no antimicrobial, was used as a contro. ‘ ACTI-Gard drape was not significantly better than ‘Steri-Drape 2 in reducing any of the microorganism tested at alltime points tested. ‘* Microban drape was not significantly better than Steri-Drape 2 in reducing any of the microorganism tested at alltime points tested. In vitro Time-Kill" 5. suru MRSA seacthiniesnid sb ora ‘Microbial Log Reduction Drape and Time (minutes) Fig. 18, 1. Eyberg, CE, MS, Morse, DJ, MS, Olson LK, BS, and Parks, P., MD, PhD. 2008. Anin vio Time-kil Study to Compare the Antimicrobial Activity of Tree Atinicrobial Surgical Incse Drapes. 1th Annual Scintic Meeting of the Society for Heathcare Epidemiology of America (SHEA), March 19-22, 2008, San Diego, CalfloraOrdering Information ia re 4 Apolo cover 60 ain. Sse eP a tr ige ceso | SM Duan Provedres™ trace rem | 20 | 4 tad CV, spine, total hip and knee, Seam cane q ‘Application covers 80 sq. in. ei aes oe Nice ocos | SMO fe [Besoin tw | 3 e tnd hand, angiography, heed i se nechececlose SM oben" 2 Antimicrobial nese Drapes with paper ner SM ban 2 Antinirobil ae76'x7875" e035 Incise Drape 10cm x 20cm Ld 4 ry {3M loban 2 Antimierobial wrest inciee Drope ° 7 34cm x 35cm ae 2M loban 2 Antimicrobial haa ‘56cm x 45cm Incise Drape Incise Drape ‘S6emx 60em a {3M loban 2 Antimierobial 22x33" inciee Drope ° 7 ‘56cm x 85cm cote | SMloban2Aninirbal wm zs » : 3M" loban2 Antimicrobial Incise = EZwith ee liner owe: [ever RS o 6 cowcez | Sumsceremt | Bihan es oro | fletmaternens a Taeen es coz | Renee | Bava es coe | cee ES esFor more information on how to protect patients against microbial contamination or to request a free sample, contact your 3M account representative. References 1 Roberts AJ, Wileox K, DevineniR, Haris RB, Otavala MA. Skin preparations in CABG surgery:@ prospective randomized wial. Come Surg. 1995;16:724,7a1—4 747 2 Stahl JB, Morse D, Parks Pd. Resistance of antimicrobial skin preparations to saline rinse using & seeded bacteria model. Am J infect Cantrol.2007;35:367-73. ‘3 Alexander JW, Aer’ S,Pletner JP. Development of a safe and effective one-minute preoperative ‘kin preparation. rch Surg, 1985:120:1967-61, 4 Data on fle 3M Study EM-05-O1356!, 3M Health Care. 5 Swenson BR, Hedrick TL, Metzger R, BonattiH, Pruett TL, Sawyer RG. Effects of preoperative ‘kin preparation on postoperative wound infection rates: a prospective study of 3 skin preparation protocols. Infect Control Hosp Epidemiol. 2009;30:964-71 {6 Karpanen Td, Worthington T, Conway BR, Hitton AC, Eliott TSJ, Lambert PA. Penetration of Chlorhexidine into human skin. Antimicrob Agents Chemother. 2008:52:3633-6, 7 Casey AL, Karpanen TJ, Nightingale P, Conway BR, and Eliott TS. Antimicrobial activity and ‘kin permeation of iodine present in an iodine-impregnated surgical incise drape. J Antimicrobial Chemotherapy. 2018. £8 Bojko J, TarziaV, Carrozzini M, etal. Comparison of efficacy and cost of iodine impregnated drape vs. standard drape in cardiac surgery: study in 5100 patients. J Cardiovasc Trans! Res. 2016:8:431-7, ‘8YoshimuraY, Kubo S, HirohashiK, et al. Plastciodophor drape during liver surgery operative use ‘ofthe iodophor-impregnated adhesive drape to prevent wound infection during high risk surgery. World J Surg.2008:27:685-8. 2M Infection Prevention Division ‘3M, loban, and DuraPrep are trademarks of 3M Company. Used under license by 3M subsidiaries and afiates. 3M Center, Building 275-46-01 CChloraPrepis a trademark of Becton, Dickinson and Compary. St. Paul, MN 55144-1000 Usa Please recycle. Printedin the USA. 200-228-3957 (© 3M 2077. All rghts reserved. \wovw.3M com/Medical 70-9700-0106-4To know more how we can start collaborating, and know more about our wide-range of solutions drop us a message MELLANY PHI CO ean a ee eta eal ery etsy eae Science. Applied to Life.” To know more how to gain access to educational contents at your own pacing and continue learning, scan the QR Code: 2 . https://tinyurl.com/3MHCA2021