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David V. Pecora, M.D.
AMA Arch Surg. 1960;80(6):1056. doi:10.1001/archsurg.1960.01290230174029.
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To the Editor:  —On numerous occasions one hears or sees printed statements to the effect that it is difficult to sterilize the skin for surgical operations because hair follicles and glands normally harbor micro-organisms, usually staphylococci. For this reason it is claimed that, no matter how well the surface of the skin is cleansed, perspiration will tend to recontaminate it. Indeed, the numerous devices which have been used to exclude the skin surfaces from the operative field attest the widespread acceptance of this belief.As a continuation of studies previously published (A.M.A. Arch. Surg. 79:632, 1959) we have attempted to determine the validity of the assumption that bacteria normally reside in the deeper skin recesses. We have cultured full-thickness pieces of skin taken from the wound margins after the completion of 65 consecutive "clean" major operations. Preoperative preparation was performed with hexachlorophene (pHisoHex) and water, chloroform, iodine tincture, and alcohol.


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