Chloraprep vs Duraprep in the Cath Lab

[czekit7]

At a recent SCIP meeting, and the surgical group stated that they no longer use Duraprep for their surgical procedures due to Duraprep's ineffectiveness after blood contact. For some reason, I can't find any information on effectiveness (or lack of) Duraprep when coming into contact with blood; nor, can I get a rep to contact me from Chloraprep or Duraprep. Any suggestions or comments??

[VLGRN]

Iodine is rendered non effective in the presence of blood and organic material. So when incision/insertion is initiated, the iodine/iodophor based preps become inactivated and no longer have efficacy against bacteria on the skin. Jan 2010 NEJM printed a significant SSI study. Results: ChloraPrep decreased infections by 41% compared to scrub/paint (iodine/iodophors). DuraPrep's active ingredient.

[RedSox8]

I'm surprised that the Cath Lab decided to switched based on heresay. I was curious and went to the DuraPrep website and pulled up the following from the Common Questions section:

Question:

What is Iodine Povacrylex?

Answer:

Iodine povacrylex is a proprietary iodine acrylate copolymer developed by 3M scientists,

an example of 3M innovation. This copolymer provides several benefits: superior

resistance to removal by blood and irrigating solutions compared to non-copolymer

formulations (e.g. Betadine® scrub and/or paint), continued antimicrobial activity after

blood and saline exposure, and excellent drape adhesion compared to non-copolymer

formulations of either povidone iodine (PVP-I) or chlorhexidine gluconate (CHG).

Question:

What is the difference between Betadine® (povidone iodine [PolyVinylPyrrilidone-

Iodine]) and iodine povacrylex?

Answer:

Betadine is the tradename for povidone iodine (PVP-I) manufactured by Purdue Pharma.

There are many generic PVP-I formulations available today.

Considering DuraPrep solution and povidone iodine: There are many similar

characteristics between the two Polymer-Iodine complexes. Both complex iodine and

release free iodine which is the component that is bactericidal in all iodine-based skin

antiseptics. Both have the same pyrrilidone ring (complexing vehicle), but unlike

Povidone-Iodine which is water soluble, the addition of the acrylate copolymer in

DuraPrep solution provides the ability for the iodine to remain on the skin during

irrigation and other stresses during surgery rather than wash away. It allows the

continual release of free iodine which kills bacteria while the film is on the skin. This

water-insoluble DuraPrep film also provides enhanced drape adhesion and immobilizes

the bacteria remaining on the skin after prepping, helping to prevent migration of the skin

flora where it may be carried into the incision through irrigation, instruments and gloves.

These features enable DuraPrep solution to maintain skin flora counts below baseline for

at least 48 hours* after exposure to blood and saline. DuraPrep solution's novel iodine

povacrylex polymer provides many differentiating features compared to traditional PVPI.

Kills major pathogens in one minute{1}(in vitro){2}

Kills 99.999% gentamicin-resistant and vancomycin-resistant Enterococci (VRE) in one minute{1} versus a leading aqueous iodophor's kill in 10 minutes(in vitro){2}

Meets the TFM required log reduction with a single, painted coat (in vivo)

Effective in a single, painted coat

Effective after exposure to blood

Resists removal by blood and irrigating solutions

Indicated for use on intact skin procedures including lumbar puncture