RecruitingPhase 2ACTRN12612001051831

Intranasal white petrolatum versus chlorhexidine to reduce postoperative infections in dermatologic surgery

In patients scheduled for dermatologic surgery, is intranasal white petrolatum or chlorhexidine more effective than normal saline in reducing postoperative infections?

Sponsor

Eugene Tan

Enrollment

2,000 participants

Start Date

Sep 16, 2013

Study Type

Interventional

Conditions

Incidence of postoperative wound infections Prevalance of staphylococcus aureus carriage Skin Cancer

Summary

New Zealand has the highest rate of skin cancers in the world which leads to a large number of skin excisions. About 30-40% of the population carry a bacterium known as Staphylococcus aureus. Carriage of this bacterium has been shown to increase the risk of surgical wound infections by up to eight times. Earlier studies have assessed the effectiveness of a topical antibiotic, mupirocin to eradicate carriage of Staphylococcus aureus. Unfortunately, this method has been complicated by bacterial resistance and allergic skin reactions. In this study, we want to see whether applying white petrolatum (Vaseline) or Chlorhexidine is effective for eradicating nasal carriage of staphylococcus aureus and reducing wound infections in dermatologic surgery. If proven to be effective, this simple method may be a safe and economic method to reduce the incidence of wound infections in dermatologic surgery.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Plain Language Summary

Simplified for easier understanding

This study is testing whether applying white petrolatum (plain Vaseline) or chlorhexidine (an antiseptic) inside the nose before skin cancer surgery can reduce the risk of wound infections. About 1 in 3 people carry a bacterium called Staphylococcus aureus in their nose, and this bacterium is a major cause of surgical wound infections. New Zealand has the world's highest rate of skin cancers, making infection prevention after skin surgery a real public health concern. An earlier antibiotic cream (mupirocin) has caused resistance problems, so researchers are testing safer alternatives. You may be eligible if: - You are 18 years or older - You are scheduled for elective skin cancer removal surgery You may NOT be eligible if: - You currently have an active infection - You are on antibiotic treatment at the time of surgery - You have used antibiotics in the month before surgery - You did not have a nasal swab taken before surgery to check for S. aureus Talk to your doctor about whether this trial might be right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

Referrals to the Skin Centre for excision of skin cancers will be selected for possible inclusion by one of five participating Consultant Dermatologists. Eligible and consenting patients will at the time of consultation for surgery, fill in a short questionnaire for demographic data and have a nasal swab to assess staphylococcus aureus carriage. The patients will be randomised to either intranasal white petrolatum, 2% chlorhexidine or normal saline to the anterior nares. Five days prior to elective surgery, all patients will apply one of three treatments (depending on randomisation) to the anterior nares twice daily. In the chlorhexidine arm and the normal saline arm, this will be in the manner of a soaked cotton bud whereas in the white petrolatum arm, this will be in the manner of a cotton bud application. All patients will have their wound assessed at the time of suture removal (expected range: 5 – 14 days depending on type of surgery) or if any clinical signs of wound infection occur outside this time frame (up to one month post-surgery). All infected wounds will be swabbed. The incidence of wound infection will be collected and a comparison will be made to the incidence of wound infection in patients being treated with intranasal white petrolatum, 2% chlorhexidine and individuals using intranasal normal saline.