title: Preoperative skin antiseptic preparations for preventing surgical site infections: a systematic review.
abstract: OBJECTIVE
  To evaluate the clinical effectiveness of preoperative skin antiseptic preparations and application techniques for the prevention of surgical site infections (SSIs).
  
  
  METHODS
  Systematic review of the literature using Medline, EMBASE, and other databases, for the period January 2001 to June 2011.
  
  
  METHODS
  Comparative studies (including randomized and nonrandomized trials) of preoperative skin antisepsis preparations and application techniques were included. Two researchers reviewed each study and extracted data using standardized tables developed before the study. Studies were reviewed for their methodological quality and clinical findings.
  
  
  RESULTS
  Twenty studies (n = 9,520 patients) were included in the review. The results indicated that presurgical antiseptic showering is effective for reducing skin flora and may reduce SSI rates. Given the heterogeneity of the studies and the results, conclusions about which antiseptic is more effective at reducing SSIs cannot be drawn.
  
  
  CONCLUSIONS
  The evidence suggests that preoperative antiseptic showers reduce bacterial colonization and may be effective at preventing SSIs. The antiseptic application method is inconsequential, and data are lacking to suggest which antiseptic solution is the most effective. Disinfectant products are often mixed with alcohol or water, which makes it difficult to form overall conclusions regarding an active ingredient. Large, well-conducted randomized controlled trials with consistent protocols comparing agents in the same bases are needed to provide unequivocal evidence on the effectiveness of one antiseptic preparation over another for the prevention of SSIs.
authors.affiliation: Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada. chrisk@cadth.ca
authors.forename: Chris
authors.initials: C
authors.lastname: Kamel
authors.forename: Lynda
authors.initials: L
authors.lastname: McGahan
authors.forename: Julie
authors.initials: J
authors.lastname: Polisena
authors.forename: Monika
authors.initials: M
authors.lastname: Mierzwinski-Urban
authors.forename: John M
authors.initials: JM
authors.lastname: Embil
mesh_terms: D000279:Administration, Cutaneous; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001494:Baths; D006801:Humans; D011300:Preoperative Care / Q000379:methods*; D012867:Skin / Q000382:microbiology; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000891:Anti-Infective Agents, Local