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Most skin surgery is done under clean, but rarely sterile, conditions, yet the rate of wound infection is surprisingly low. This in vitro study assessed the bactericidal and bacteriostatic properties of lidocaine with and without epinephrine (1:100,000) by adding a suspension containing 105 colony-forming units of bacteria to various lidocaine concentrations (0%,1%, 2%, and 4%) and controls.
E. coli was most susceptible, with bactericidal activity noted at all lidocaine concentrations. Lidocaine was bactericidal for P. aeruginosa at 2% and 4%, but 1% only slowed bacterial growth. Lidocaine at 4% was bactericidal for E. faecalis and S. aureus and mildly bacteriostatic at lower concentrations. The addition of epinephrine to lidocaine had no ef…