Trial reportPloS one2023
Quality of lower limb preoperative skin preparation using colorless versus colored disinfectants-results of an experimental, randomized study in a close to reality setting.
Trial report in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- [Recommendations for perioperative skin care in total joint arthroplasty: antimicrobial wash lotion, precleaning and hair removal].Orthopadie (Heidelberg, Germany) · 2025Pooled it
- Preoperative skin asepsis in bovine surgery: an outcome-blinded 3-arm randomized clinical trial under non-sterile operating room conditions.Frontiers in veterinary science · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAppropriate preoperative skin cleansing is important to control surgical site infections. Both colored and colorless skin disinfectants are available, however certain types of skin preparation, such as octenidine-dihydrochloride with alcohol have a long residual antimicrobial effect but are available only in colorless form. We hypothesized that colorless skin disinfectants lead to more incomplete skin preparation of lower limbs compared to colored agents.
methodsWe randomly assigned healthy volunteers to undergo a determined skin cleansing protocol for total hip arthroplasty in the supine position to either a colored or colorless skin cleansing protocol. The adequacy of skin preparation was compared between orthopedic consultants and residents. The colorless disinfectant was mixed with a fluorescent dye and missed skin areas were visualized using UV lamps. Both preparations were photo-documented following standardized protocols. The primary outcome of interest was the number of legs with an incomplete scrubbed area. The secondary outcome was the cumulative skin area not disinfected.
resultsFifty-two healthy volunteers (104 legs; 52 colored and 52 colorless) underwent surgical skin preparation. The number of legs incompletely disinfected was significantly higher in colorless compared to colored disinfectant group (38.5% (n = 20) vs. 13.5% (n = 7); p = 0.007). Regardless of the disinfectant, consultants performed better than the residents. When using colored disinfectant, residents incompletely prepared the site in 23.1% (n = 6) compared with 57.7% (n = 15) with a colorless disinfectant (p = 0.023). Conversely consultants using colored disinfectant incompletely prepared the site in 3.8% (n = 1) compared with 19.2% (n = 5) for colorless disinfectant (p = 0.191). The total amount of uncleansed skin was significantly higher using colorless skin disinfectant (mean ± standard deviation: 8.78 cm2± 35.07 vs. 0.65 cm2 ± 2.66, p = 0.002).
conclusionsApplication of colorless skin disinfectants for hip arthroplasty cleansing protocol led to decreased skin coverage among consultants and residents compared to colored preparations. Colored disinfectants remain the gold standard in hip surgery, however we should be aiming to develop newer colored disinfectants with long residual antimicrobial effects to enable visual control during the scrubbing process.
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