Publication: İki farklı ürün ile silme banyo yapılan çocukların kalıcı cilt floralarının karşılaştırılması : randomize kontrollü çalışma
Abstract
Amaç: Sağlıklı bireylerde flora, çok sayıda ve farklı mikroorganizmaları içermektedir. Enfeksiyonlar, antibiyotik kullanımı, çeşitli kimyasallar florayı değiştirebilmektedir. Bu çalışma çocuk yoğun bakım ünitesinde yatan çocukların günlük %2’lik klorheksidin glukonat ve sabunsuz vücut yıkama solüsyonu ile yapılan silme banyosunun kalıcı cilt floralarına etkisinin karşılaştırılması amacıyla yapılmıştır. Gereç ve Yöntem: Çalışma, Şubat 2021-Ocak 2022 yılında bir eğitim ve araştırma hastanesi çocuk yoğun bakım ünitesinde yatmakta olan 60 çocuk ile randomize kontrollü deneysel olarak gerçekleştirildi. Çalışmada Grup I(n=30)’ deki çocuklara sabunsuz vücut yıkama solüsyonu ile Grup II(n=30)’ deki çocuklara ise ünitenin rutin uygulaması olan %2’lik klorheksidin glukonat ile silme banyosu uygulanmıştır. Her iki grupta da 3 gün boyunca silme banyo uygulamasından hemen önce ve silme banyo uygulamasından 6 saat sonrasında koltukaltı ve kasıktan sürüntü örnekleri alınmıştır. Bulgular: Çalışmamıza katılan çocukların %36,7 (n=22)’si kız, %63,3 (n=38)’ü erkektir. Katılımcıların ortalama yaşı 6,05±5,04 olarak belirlenmiştir. Gruplar arası kalıcı cilt florasındaki üreme değişimleri incelendiğinde 1., 2. ve 3. günlerde banyo öncesi ve sonrasında Grup I ve Grup II arasında anlamlı düzeyde farklılık saptanmıştır (p=0,001). 1. günde Grup II’de kalıcı cilt florası anlamlı düzeyde azalırken, 2. ve 3. günlerde ise tamamen yok olmuştur. Grup I’de ise 3 gün boyunca kalıcı cilt florası korunmaya devam etmiştir. Sonuç: Araştırma sonucunda çocuk yoğun bakım ünitesinde yatan çocuklarda %2’lik klorheksidin glukonatlı silme banyosunun koltukaltı ve kasıktaki kalıcı cilt florasını anlamlı düzeyde azalttığı saptanmıştır. Rutin uygulamada bazı çocuk yoğun bakım ünitelerinde %2’lik klorheksidin glukonat ile silme banyosu enfeksiyonların azaltılması ve önlenmesi amacıyla kullanılmaktadır. Ancak çalışmamızdan elde edilen bulgular doğrultusunda kalıcı cilt florasını bozması sonucu derinin koruyucu fonksiyonun olumsuz etkilenmesi ve kimyasal bir ürün olması nedeniyle silme banyoda %2’lik klorheksidin glukonatın rutin olarak kullanılması önerilmemektedir.
Objective: Microbiota in healthy individuals includes many and different microorganisms. Infections, use of antibiotics, various chemicals (antiseptic solutions, soaps, shampoos, etc.) can change the human microbiota. This study was planned to compare the effect of wiping bath with 2% daily chlorhexidine gluconate and soap-free body washing solution on the skin microbiota of the patients hospitalized in the PICU. Material and methods: The research was carried out as a randomized controlled experimental study with 60 children hospitalized in the pediatric intensive care unit of a training and research hospital in February 2021- January 2022. In the study, the children in Group I (n=30) were given a soap-free body wash solution and the children in Group II (n=30) were given a wiping bath with 2% chlorhexidine gluconate, which is the routine application of the unit. In both groups, swab samples were taken from the armpits and groin for 3 days just before the application of the wiping bath and 6 hours after the application of the wiping bath. Results: Children participating in the study 36.7% (n=22) were girls and 63.3% (n=38) were boys. The mean age of the participants was determined as 6.05±5.04. When the reproductive changes in the permanent skin flora between the groups were examined, a significant difference was found between Group I and Group II before and after bathing on the 1st, 2nd and 3rd days (p=0.001). Persistent skin flora decreased significantly in Group II on the 1st day, while it disappeared completely on the 2nd and 3rd days. In Group I, the permanent skin flora continued to be preserved for 3 days. Conclusion: As a result of the research, it was determined that 2% chlorhexidine gluconate wiping bath in children hospitalized in the PICU significantly reduced the persistent skin flora in the armpits and groin. In routine practice, wiping bath with 2% chlorhexidine gluconate is used in some pediatric intensive care units to reduce and prevent infections. However, in line with the findings of our study, it is not recommended to routinely use 2% chlorhexidine gluconate in wiping baths, since it disrupts the persistent skin flora, negatively affects the protective function of the skin and is a chemical product.
Objective: Microbiota in healthy individuals includes many and different microorganisms. Infections, use of antibiotics, various chemicals (antiseptic solutions, soaps, shampoos, etc.) can change the human microbiota. This study was planned to compare the effect of wiping bath with 2% daily chlorhexidine gluconate and soap-free body washing solution on the skin microbiota of the patients hospitalized in the PICU. Material and methods: The research was carried out as a randomized controlled experimental study with 60 children hospitalized in the pediatric intensive care unit of a training and research hospital in February 2021- January 2022. In the study, the children in Group I (n=30) were given a soap-free body wash solution and the children in Group II (n=30) were given a wiping bath with 2% chlorhexidine gluconate, which is the routine application of the unit. In both groups, swab samples were taken from the armpits and groin for 3 days just before the application of the wiping bath and 6 hours after the application of the wiping bath. Results: Children participating in the study 36.7% (n=22) were girls and 63.3% (n=38) were boys. The mean age of the participants was determined as 6.05±5.04. When the reproductive changes in the permanent skin flora between the groups were examined, a significant difference was found between Group I and Group II before and after bathing on the 1st, 2nd and 3rd days (p=0.001). Persistent skin flora decreased significantly in Group II on the 1st day, while it disappeared completely on the 2nd and 3rd days. In Group I, the permanent skin flora continued to be preserved for 3 days. Conclusion: As a result of the research, it was determined that 2% chlorhexidine gluconate wiping bath in children hospitalized in the PICU significantly reduced the persistent skin flora in the armpits and groin. In routine practice, wiping bath with 2% chlorhexidine gluconate is used in some pediatric intensive care units to reduce and prevent infections. However, in line with the findings of our study, it is not recommended to routinely use 2% chlorhexidine gluconate in wiping baths, since it disrupts the persistent skin flora, negatively affects the protective function of the skin and is a chemical product.