Ping: Eaglesfan27

[duckman]

I realize that you don't deal with this sort of thing, but I figured I would ask anyway. :)

Do you know what the purpose of using chlorhexdine gluconate mouthwash (0.12% concentration) the night prior to and morning of a surgery? Just curious.

[Eaglesfan27]

Off of the top of my head, no I don't know the purpose of that. I'm sure I could find out in one of my text books however.

[duckman]

Off of the top of my head, no I don't know the purpose of that. I'm sure I could find out in one of my text books however.
Thanks. I really appreciate it.

[Eaglesfan27]

Sure, I'm on call tonight (this is the first night that my ear infection has improved enough to actually take call) and just called to go see a patient, but I'll check on in it an hour or two when I get back. Hopefully, that won't be too late to be of use to you.

[duckman]

Hopefully, that won't be too late to be of use to you.
I'm not having the surgery until Tuesday, so there is no big rush. I received this stuff from the hospital through the mail with no explanation, so I am naturally curious as its purpose. I appreciate you taking the time to find out.

[ThunderingHERD]

Google:

Chlorhexidine gluconate is an antiseptic and disinfectant agent, which is active against various bacteria, viruses, bacterial spores and fungi. It kills the micro-organisms associated with various mouth and throat infections, and other common conditions in the mouth. These include the Candida albicans fungi that causes thrush infection in the mouth, and bacteria that may infect mouth ulcers or other sore areas in the mouth, eg after dental surgery. Infection of these areas increases discomfort and delays healing. Chlorhexidine has also been shown to prevent the formation and build up of plaque on teeth, which helps prevent inflammation of the gums (gingivitis). It can therefore be used as an aid to oral hygiene, particularly in instances where toothbrushing is a problem, eg following dental surgery or in physically or mentally handicapped people. Chlorhexidine is available as a mouthwash, a spray or a dental gel for the treatment of common dental conditions. The gel is used to brush the teeth, or for direct application to sore areas in the mouth. The action of rinsing the mouth with the mouthwash provides a mechanical cleaning action in the mouth. The spray is applied to tooth and gum surfaces, ulcers and other sore areas. All kill micro-organisms in the areas they are in contact with and help maintain oral hygiene.

[duckman]

Interesting. I wonder why someone having spinal surgery would need something for dental purposes. :confused:

[terpkristin]

Well in your spine surgery they will stick a tube down your throat (they do it with all general anesthesia, to breathe for you). So maybe they're afraid there will be some bacteria there....

At least that's all I can come up with. On none of my surgeries with general anesthesia have they ever suggested I use that or anything like that. Uh, that's out of 5 GA surgeries.

/tk

[JonInMiddleGA]

Now I'm just totally going off the wall here, so please don't let this question cause any concern if the answer is no, but ... are they planning to put you on a ventilator or something of that nature during the surgery?

The reason I ask was the specific mention in that citation about this stuff killing off the bacteria that causes thrush. From some experiences with my father-in-law, I know that ventilators & thrush sometimes go together (although that's usually more long-term use AFAIK).

Otherwise ... maybe they're planning to snag a couple of teeth while they're working on you ;)

[Eaglesfan27]

I just got back, and it is an oral antiseptic as reliable google said. It is standard procedure for spinal surgery according to my text book. Basically, the reason it is done is that oral cavity is in close physical proximity to the surgical field that they will be working in. They just want to make sure that the surgical field is sterile as possible, since there is a chance that you will have some oral secretions while you are under the anesthesia.

[kcchief19]

Perhaps just preventive to help ward off an post-operative infections? How long will you be out? Perhaps related to the length of time you'll be under a mask? Just thinking out loud. I wasn't told this when I had knee surgery, but then again I was only in the OR for less than two hours.

[duckman]

Here is what I found:

• Background Decreasing the levels of bacteria in the oropharynx<SUP> </SUP>should reduce the prevalence of nosocomial pneumonia.<SUP> </SUP>


• Objectives To test the effectiveness of 0.12% chlorhexidine<SUP> </SUP>gluconate oral rinse in decreasing microbial colonization of<SUP> </SUP>the respiratory tract and nosocomial pneumonia in patients undergoing<SUP> </SUP>open heart surgery.<SUP> </SUP>

• Methods A prospective, randomized, case-controlled clinical<SUP> </SUP>trial design was used. Peridex (0.12% chlorhexidine gluconate)<SUP> </SUP>was the experimental drug, and Listerine (phenolic mixture)<SUP> </SUP>was the control drug. A total of 561 patients undergoing aortocoronary<SUP> </SUP>bypass or valve surgery requiring cardiopulmonary bypass were<SUP> </SUP>randomized to an experimental (n = 270) or a control (n = 291)<SUP> </SUP>group. Nosocomial pneumonia was diagnosed by using the criteria<SUP> </SUP>established by the Centers for Disease Control and Prevention.<SUP> </SUP>

• Results The overall rate of nosocomial pneumonia was<SUP> </SUP>reduced by 52% (4/270 vs 9/291; P = .21) in the Peridex-treated<SUP> </SUP>patients. Among patients intubated for more than 24 hours who<SUP> </SUP>had cultures that showed microbial growth (all pneumonias occurred<SUP> </SUP>in this group), the pneumonia rate was reduced by 58% (4/19<SUP> </SUP>vs 9/18; P = .06) in patients treated with Peridex. In patients<SUP> </SUP>at highest risk for pneumonia (intubated >24 hours, with<SUP> </SUP>cultures showing the most growth), the rate was 71% lower in<SUP> </SUP>the Peridex group than in the Listerine group (2/10 vs 7/10;<SUP> </SUP>P = .02).<SUP> </SUP>• Conclusions Although rates of nosocomial pneumonia were<SUP> </SUP>lower in patients treated with Peridex than in patients treated<SUP> </SUP>with Listerine, the difference was significant only in those<SUP> </SUP>patients intubated more than 24 hours who had the highest degree<SUP> </SUP>of bacterial colonization.

[JonInMiddleGA]

So basically, this is to help prevent infections caused by your own drool.
Charming.

;)

[Eaglesfan27]

So basically, this is to help prevent infections caused by your own drool.
Charming.

;)
Yep ;)

[duckman]

I just got back, and it is an oral antiseptic as reliable google said. It is standard procedure for spinal surgery according to my text book. Basically, the reason it is done is that oral cavity is in close physical proximity to the surgical field that they will be working in. They just want to make sure that the surgical field is sterile as possible, since there is a chance that you will have some oral secretions while you are under the anesthesia.
Cool. It makes sense because of where they are working at (base of the neck). I was just got curious when I found the stuff in my mail this afternoon.

[duckman]

How long will you be out?
I'm not sure. That'll be explained to me during my preoperative appointment on Monday. The lead surgeon told me this past Monday that they may have to resection and fuse vertebraes in my neck if the bony tumor is cancerous. I would think at least a couple hours if they just remove the growth.