BPO vs Hibiclens Soap for Surgical Preparation

Phase 4

Completed

Brief Summary: This is a randomized trial of benzoyl peroxide soap versus Hibiclens soap for surgical preparation. The objective is to determine whether benzoyl peroxide soap, commonly available in drug stores for over-the-counter acne treatment, is as or more effective than the standard surgical preoperative soap, Hibiclens soap (chlorhexidine gluconate), in reducing loads of Propionibacteria (Propi) on or under the skin of patients prior to shoulder arthroplasty (joint replacement).

Recruitment & Eligibility

Inclusion Criteria

Male subjects
Subjects scheduled for elective shoulder arthroplasty at the University of Washington Medical Center
Subjects between ages 18-89

Exclusion Criteria

Subjects who self-report very sensitive skin
Subjects who are sensitive to benzoyl peroxide
Subjects who are allergic to chlorhexidine
Subjects who had recent prior use of antibiotics (or expect to use them prior to surgery)
Subjects who had recent use of acne treatment
Subjects who are not fluent in English.

Arm && Interventions

Group	Intervention	Description
BPO Soap	Benzoyl Peroxide 10% Bar	-
Hibiclens Soap	Chlorhexidine Gluconate	-

Primary Outcome Measures

Name	Time	Method
Number of Patients With a Positive Propionibacteria Swabs on Day of Surgery After At-Home Washes With Benzoyl Peroxide or Chlorhexidine Gluconate	Day of Surgery	Patients were randomly assigned to use either benzoyl peroxide soap or Hibiclens soap (chlorhexidine gluconate) at home the night before and the morning of surgery. On the day of surgery the patients' skin and incisions were swabbed in the operating room prior to shoulder arthroplasty. Specimens were held for 21 days.
Number of Quadrants on Culture Plate of Propionibacteria Growth - Specimens Taken Day of Surgery After At-Home Washes With Benzoyl Peroxide or Chlorhexidine Gluconate	Day of Surgery	This outcome measures the load of Propionibacteria on the skin and incision of participants in the operating room prior to shoulder arthroplasty when patients were randomly assigned to use either benzoyl peroxide soap or Hibiclens soap (chlorhexidine gluconate) at home the night before and the morning of surgery. The Propionibacteria load was quantified based on the growth of bacteria on the agar plate using a quadrant system. Quantitative specimen Propionibacteria values (SpCuVs) were assigned as following: "no growth"= 0, "broth only"= 0.1, "one colony only"= 0.1, and 1 quadrant growth = 1, 2 quadrant growth = 2, 3 quadrant growth = 3, and 4 quadrant growth = 4. Samples were taken on the day of surgery and the cultures were held for 21 days.

Secondary Outcome Measures