Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
The Effect of Chlorhexidine Gluconate on Microbial Growth in Patients Undergoing Debridement for Diabetic Foot:A Randomized Controlled Study
Diyabetik Ayak Nedeniyle Debridman Uygulanan Hastalarda Klorheksidin Solüsyonunun Mikroorganizma Üremesi Üzerine Etkisi: Randomize Kontrollü Çalışma
Dilek TALHAOĞLUa , Gülsüm Nihal ÇÜRÜKb
aDepartment of Medical Services and Techniques, Osmaniye Korkut Ata University Health Services Vocational School, Osmaniye, Türkiye
bDepartment of Nursing, İzmir University of Economics Faculty of Health Sciences, İzmir, Türkiye
Turkiye Klinikleri J Nurs Sci. 2023;15(4):1139-46
doi: 10.5336/nurses.2023-96176
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study was to determine the effect of chlorhexidine gluconate on microbial growth in patients undergoing debridement for diabetic foot. Material and Methods: The study had a randomized, controlled experimental design. The study sample included a total of 60 patients. Of 60 patients, 30 were randomly assigned into the experimental group and 30 were randomly assigned into the control group. In the experimental group, the surgical site was washed with chlorhexidine gluconate 0.05% before and after debridement in addition to routine cleaning with povidone iodine before debridement. In the control group, all the steps of the procedure performed in the experimental group were followed except for using chlorhexidine gluconate 0.05%. Results: The experimental and control groups were found to be similar in terms of descriptive characteristics and diabetesrelated features. There was no difference in the presence of microorganisms before debridement between the experimental and control groups, but fewer species were isolated from the experimental group after debridement. The mean number of isolated species in the experimental group was 1.66±0.60 and 0.60±0.67 before and after debridement respectively. The mean number of isolated species in the control group was 1.06±0.58 and 1.10±0.75 before and after debridement respectively. Conclusion: It can be concluded that chlorhexidine gluconate and povidone iodine used before debridement are effective in reduction of the number of microbial species after debridement in patients with diabetic foot.

Keywords: Diabetic foot; preoperative skin preparation; infection; microorganism; nursing
ÖZET
 Amaç: Araştırma, diyabetik ayak nedeniyle debridman uygulanan hastalarda klorheksidin solüsyonunun mikroorganizma üremesi üzerine etkisini belirlemek amacıyla yapılmış randomize kontrollü deneysel bir çalışmadır. Gereç ve Yöntemler: Çalışma müdahale grubunda 30, kontrol grubunda 30 olmak üzere toplam 60 hasta ile tamamlanmıştır. Müdahale grubundaki hastalara debridman öncesi rutin uygulanan povidon iyotlu cerrahi bölge temizliğine ek olarak %0,05'lik klorheksidin solüsyonuyla yıkama yapılmış, debridman sonrası tekrar klorheksidinle temizleme yapılarak pansuman kapatılmıştır. Kontrol grubunda deney grubundan farklı olarak %0,05'lik klorheksidin glukonatlı solüsyon kullanılmamış, diğer işlemler deney grubunda olduğu gibi uygulanmıştır. Bulgular: Müdahale ve kontrol grubundaki hastaların tanıtıcı özellikleri ve diyabete ilişkin özellikleri bakımından benzer olduğu görülmüştür. Müdahale ve kontrol grubunda debridman öncesi mikroorganizma varlığı açısından fark bulunmazken, debridman sonrası müdahale grubunda daha az sayıda mikroorganizma ürediği tespit edilmiştir. Müdahale grubunda debridman öncesi ve sonrası bakteri üreme ortalaması sırasıyla 1,66±0,60 ve 0,60±0,67 olarak saptanmıştır. Kontrol grubunda debridman öncesi ve sonrası bakteri üreme ortalaması ise sırasıyla 1,06±0,58 ve 1,10±0,75 olarak tespit edilmiştir. Sonuç: Araştırma bulgularımıza dayanarak, diyabetik ayağı olan bireylerde debridman öncesi uygulanan klorheksidin solüsyonunun debridman sonrası mikroorganizma sayısını azaltmada etkili olduğu söylenebilir.

Anahtar Kelimeler: Diyabetik ayak; preoperatif cilt hazırlığı; enfeksiyon; mikroorganizma; hemşirelik
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