Presurgical skin preparation with a novel 2% chlorhexidine gluconate cloth reduces rates of surgical site infection in orthopaedic surgical patients.
BACKGROUND
Postoperative surgical site infections (SSIs) are a common complication of joint surgery. Prevention depends on adequate preoperative skin antisepsis. In previous studies, use of a 2% chlorhexidine gluconate (CHG) no-rinse cloth reduced SSI rates in general surgery patients.


METHODS
Patients admitted for a total joint procedure used a skin antisepsis protocol incorporating 2% CHG no-rinse cloths to do a site-specific wash on the night before surgery and in the holding area just before surgery.


RESULTS
In the 3 quarters before implementation of the protocol, the SSI rate was 3.19%. In the 3 quarters after the 2% CHG cloth was introduced, the SSI rate decreased to 1.59%, representing a 50.16% reduction in SSIs.


CONCLUSIONS
The rate of SSI was cut in half after the introduction of 2% CHG no-rinse cloths in the place of a povidone-iodine (Betadine) skin antiseptic in orthopaedic patients undergoing total joint procedures. Further testing using randomization comparative protocols are required to conclude that the decreased SSI was in fact a direct result of the 2% CHG protocol.
Eiselt
Debra
D
Debra Eiselt, BSN, RN, Employee Health Coordinator, Infection Prevention & Control, Lakeview Hospital, Stillwater, MN, USA.
D000287:Administration, Topical; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D009985:Orthopedics; D011300:Preoperative Care; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000891:Anti-Infective Agents, Local; C010882:chlorhexidine gluconate; D002710:Chlorhexidine