title: Effect of 4% chlorhexidine gluconate predisinfection skin scrub prior to hepatectomy: a double-blinded, randomized control study.
abstract: This trial was designed to compare the efficacy of 4% chlorhexidine gluconate (CHG) with normal saline (NS) as a predisinfection skin-scrub solution prior to standard presurgical skin preparation. Data was collected at a single transplantation center where patients electing resection of hepatic tumors were recruited between October 2011 and September 2012. In total, 100 patients were consecutively enrolled for random assignment to either 4% CHG or NS as a predisinfection skin-scrub solution prior to surgery. Our aim was to assess the comparative antiseptic efficacy of CHG in this setting, focusing on cutaneous microbial colonization (at baseline, preoperatively, and postoperatively) and postsurgical site infections as primary outcome measures. Positivity rates of baseline, preoperative, and postoperative cultures were similar for both groups, showing significant declines (relative to baseline) after skin preparation and no significant postsurgical rebound. Rates of surgical site infection were also similar in both groups (CHG, 6.0%; NS, 4.1%; P = 1.0). For patients with hepatic tumors undergoing hepatectomy, the effect of 4% CHG as a predisinfection scrub solution was similar to that of NS in terms of skin decontamination and surgical site infections.
authors.affiliation: 1 Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Ching-Shui
authors.initials: CS
authors.lastname: Hsieh
authors.forename: Hsiu-Chi
authors.initials: HC
authors.lastname: Cheng
authors.forename: Jen-Shiou
authors.initials: JS
authors.lastname: Lin
authors.forename: Shou-Jen
authors.initials: SJ
authors.lastname: Kuo
authors.forename: Yao-Li
authors.initials: YL
authors.lastname: Chen
mesh_terms: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000494:pharmacology; D004203:Disinfection / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012867:Skin / Q000187:drug effects* / Q000382:microbiology*; D012965:Sodium Chloride; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D012965:Sodium Chloride; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
keywords: Chlorhexidine gluconate; Hepatectomy; Predisinfection scrub; Surgical site culture; Surgical site infection