مهناز سلیمانی

One of the most important health procedures to control nosocomial infections is skin disinfection. This action is absolutely necessary to disinfect the skin before surgery. This action reduces the nosocomial infections significantly. Regarding the importance of this subject, in this study, two surgical areas: Preps with Betadine and Chlorhexidine has been compared.
This study was three stages, double-blind clinical trial that was performed on sixty-four patients who was electively candidate for hand surgery and randomly divided into two Povidone iodine 7.5% and Chlorhexidine groups. Sample for culturing was obtained from area, before, and after prep, and after operation. Data were recorded in checklist and analyzed using independent t-test, chi-square, and repeated measure of ANOVA.
Results show that bacterial levels significantly reduced and reached to zero when preparation of skin was based on chlorhexidine formulation (P=0.001). In the povidone iodine group the mean number of bacteria was reduced significantly (P=0.001) in three times. The average number of bacteria after preparation with chlorhexidine significantly reduced when compare to Povidone iodine, but after operation it not significant between two groups (P=0.770).
Although using antiseptic before surgery is essential, choosing the right solution in some cases faced with challenges. Chlorhexidine in prep before surgery could safely reduce the amount of bacteria. This study recommended using chlorhexidine rather than povidone iodine in surgical procedures, because it is more effective to reduce the number of skin surface bacteria.

Sore throat and hoarseness are the most frequent subjective complaints after tracheal intubation for general anesthesia. We conducted a prospective، randomized، double-blind، placebo controlled study to evaluate the efficacy of intravenous dexamethasone plus ketamine gargle for reducing the incidence and severity of post-operative sore throat (POST) and hoarseness. 140 patients (aged 16-65 years) scheduled for elective surgery were enrolled. Patients were randomly allocated into four groups of 35 subjects: group K gargled 40 mg ketamine in 30 ml saline; group D were infused 0. 2 mg/kg intravenous (IV) dexamethasone; group KD gargled 40 mg ketamine in 30 ml saline plus 0. 2 mg/kg intravenous dexamethasone; and group P (placebo) received saline (gargle and IV). POST was graded at 0، 2، 4، 8، 16 and 24 hours after operation on a four-point scale (0–3). The incidence and severity of POST were significantly lower in group KD، compared with the other groups at all times after tracheal extubation for up to 24 hours (P < 0. 05). Also، the incidence and severity of hoarseness were significantly lower in groups of KD، K and D compared with group P (P < 0. 05). The prophylactic use of 0. 2 mg/kg of intravenous dexamethasone plus ketamine gargle significantly reduced the incidence and severity of POST compared with using each of these drugs alone or using placebo.