To The Editor:I am writing to point out two limitations not mentioned in the study
presented in your article, "Efficacy of Surgical Preparation Solutions
in Foot and Ankle Surgery"
(2005;87:980-5), by Ostrander et
al.No neutralizing ingredient(s) (neutralizer) was used in the sampling
method, either on the swab or in the transport or culture media. American
Society for Testing and Materials (ASTM) method E1054-02 recommends adding
appropriate neutralizers to the solution used for sampling skin. A neutralizer
inactivates an antimicrobial at sampling so that there is no further kill in
the test tube while the sample is waiting to be diluted and plated for
quantification. If a neutralizer is not present, the antimicrobial will
continue to kill bacteria in vitro, resulting in an erroneous higher kill
rate. The lack of a neutralizer would inflate the efficacy of the
water-soluble preparations (Techni-Care and ChloraPrep) tested.