Infection prevention with a long-term effect

Skin antisepsis is one of the most important standards for the prevention of postoperative wound infections (SSI) and vascular catheter-associated bloodstream infections (CABSI). Preparations with a high alcohol content (≥ 60 %) are generally used for skin antisepsis, which enable a bacterial count reduction of 99 to 99.9 % with short exposure times.

When testing for efficacy, preparations in Germany must not be inferior to the reference alcohol (70% 2-propanol) tested in parallel. In the DGHM test method from 1991, a long-term effect over 24 hours was required for the preparations in addition to the short-term effect. This long-term effect is based exclusively on the fact that bacterial growth is delayed after the alcohol content in the test or reference preparation has initially greatly reduced the bacterial count.

Our products kodan^® tincture forte colored and kodan^® tincture forte colorless naturally meet this requirement. Thus, kodan^® tincture forte did not differ significantly from the reference alcohol in its efficacy against the resident skin flora on skin with few sebaceous glands [1]. Accordingly, kodan^® Tinktur forte shows by definition a long-term effect over 24 hours.

The current DGHM test methods from 2002 no longer provide evidence of such a long-term effect over 24 hours. The residual effect must be clearly distinguished from this long-term effect. This effect is achieved by active ingredients such as octenidine dihydrochloride (octenidine) or chlorhexidine. After the alcohol has dried off, these active ingredients remain on the skin for a longer period of time and continue to exert their antimicrobial properties against resident and transient flora during this time. After the alcohol has dried, the bacterial count is further reduced over time. Although the remanence effect cannot be demonstrated by standardized test methods, it can be clearly demonstrated experimentally and clinically.

The use of products with a remanent effect is particularly recommended for surgical procedures that take a long time and where there is a high risk of infection. Infections associated with (vascular) catheters or other accesses can lead to sepsis or septic shock in severe cases. Intensive care patients are particularly at risk here. In order to sustainably reduce the skin flora around the catheter entry site, the use of an alcoholic skin antiseptic in combination with a remanent active ingredient such as octenidine - e.g. octeniderm^® colorless - is therefore recommended for skin disinfection before inserting a vascular catheter.

With its remanence of 48 hours, octeniderm^® colorless is more effective in clinical comparisons than purely alcohol-based preparations or preparations based on alcohol and benzalkonium chloride. The sustained reduction of germs with octeniderm^® colorless reduces the risk of catheter-associated infections.