Efficacy of Surgical Field Disinfection of the Umbilicus in Children

• Published in: Journal of the Japanese Society of Pediatric Surgeons Vol. 60; no. 1; pp. 38 - 43
• Main Authors: Obatake, Masayuki, Fujieda, Yuki
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Pediatric Surgeons 20.02.2024; 特定非営利活動法人 日本小児外科学会
• Subjects: chlorhexidine; olanexidine; preoperative umbilical preparation; surgical site disinfection; umbilical flora; オラネキシジン; クロルヘキシジン; 臍細菌叢; 術前臍処置; 術野消毒
• ISSN: 0288-609X; 2187-4247
• DOI: 10.11164/jjsps.60.1_38

Purpose: The umbilicus is used as a common site of entrance into the peritoneum for laparoscopic and gastrointestinal surgery in children, and its anatomically concave and creased structure is expected to make surgical disinfection less effective. We assessed the effectiveness of surgical disinfection of the umbilicus in children.Methods: This study included 30 children (less than 12 years old) who underwent operations under general anesthesia between July 2020 and February 2021. Operations included inguinal hernia, undescended testis, and other minor surgeries excluding gastrointestinal tract surgery, umbilical hernia, and emergency operations. The patients were divided into three groups: 10 disinfected with 0.5% chlorhexidine gluconate, 10 disinfected with 1.5% lofexidine gluconate, and a control group. After preoperative and antiseptic umbilical preparations, the cup scrub technique was used to collect microbiological samples from the umbilicus.Results: Staphylococcus epidermidis was detected in 29 of the 30 patients, and Corynebacterium species was detected in 11. There was no significant difference in the number of colonies of all species including S. epidermidis among the three groups. Twenty-six patients had a residual umbilical plaque. No postoperative surgical site infection occurred and no adverse events were observed.Conclusions: Preoperative and antiseptic skin preparations did not reduce the umbilical microflora. Although umbilical disinfection is necessary in terms of the disinfection of the surgical field, preoperative umbilical preparations are not critical.