Underestimated role of alcohol at skin disinfection: lipid dissolving property when used in association with conventional antiseptic agents

Aim: After conventional aqueous disinfectant solutions, it was shown that microorganisms were still protected in hair follicles. We hypothesized that those aqueous disinfectant solutions when used in combination with alcohol may be more effective on the inhibition of recolonization of skin and therefore catheter tip colonization.Materials and methods: Skin surface samples were taken from epidural catheter insertion sites prior to catheterization,and before and after disinfection with different combinations of povidone-iodine, chlorhexidine, and alcohol. Before catheter removal, cultures were taken once more and tips of the catheters were cultured. Results: Catheter tip colonization and skin culture results of 10% povidone-iodine + 70% alcohol group were significantly lower than those of other groups after disinfection. Conclusion: Sequential use of alcohol and povidone-iodine is the most effective combination for limiting re-colonizationof skin flora. Contamination of catheters appears to take place at removal or via the spread of these re-colonized bacteriaalong the catheter tract.