Subcutaneous tissue disinfection is more effective than the use of electrocautery in reducing

Background: Methods: All patients who qualified for primary open shoulder surgery via a deltopectoral approach were prospectively included in our single-blinded, two-arm randomized clinical trial. For every patient, a skin swab from the surgical area was taken before the standard preparation of the skin. In the disinfection group, the subcutaneous layer was treated with povidone iodine solution after exposure of the deltoid fascia. The cautery group underwent subcutaneous tissue dissection using an electrocautery. After fully exposing the proximal humerus, 5 swabs were collected from various locations for microbiological analysis, following a rigorous protocol. All cultures were incubated for 14 days under both aerobic and anaerobic conditions. Results: Between February 2020 and July 2021, 210 shoulders were enrolled in 2 groups (140 disinfection vs. 70 cautery). The 2 groups showed no significant differences in terms of sex, age, body mass index, or diabetes prevalence. The subcutaneous disinfection protocol led to a significant decrease in the overall positive culture rate of the operating field for all bacteria ( Conclusion: Disinfection of the subcutaneous tissue reduces the contamination rate of