title: Role of antiseptics in the prevention of surgical site infections.
abstract: BACKGROUND
  Antiseptics are chemical agents used to reduce the microbial population on the surface of the skin and are used in nearly every surgical procedure today. Despite this, there are currently no definitive guidelines on surgical preoperative antisepsis that indicate a specific regimen based on demonstration of superior efficacy.
  
  
  OBJECTIVE
  This review serves to examine preoperative antisepsis, including cutaneous bacteriology, preoperative hair removal, preoperative decolonization, surgical attire, and the antiseptic agents themselves.
  
  
  METHODS
  A review of the literature on surgical antiseptics was performed.
  
  
  RESULTS
  Although numerous studies have demonstrated differences in bacterial colonization rates, few well-controlled investigations have demonstrated superiority of a given regimen. The alcohol-based iodophor and chlorhexidine products seem to exhibit greater efficacy than their aqueous counterparts.
  
  
  CONCLUSIONS
  More randomized controlled trials will be needed to determine if any specific regimen is most effective. At this point in time, product usage should be based on specific attributes relating to the products, such as iodophors around the eyes and/or ears to avoid irritation and aqueous-based solutions in hair bearing areas because of concern for flammability. Ultimately, it is up to the individual surgeon to tailor the optimal antiseptic regimen for their specific scope of practice.
authors.affiliation: *Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina; †Section of Dermatology, Department of Medicine, Medical College of Georgia, Georgia Regents University, Augusta, Georgia; ‡Total Skin and Beauty Dermatology, Birmingham, Alabama.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Echols
authors.forename: Michael
authors.initials: M
authors.lastname: Graves
authors.forename: Keith G
authors.initials: KG
authors.lastname: LeBlanc
authors.forename: Sean
authors.initials: S
authors.lastname: Marzolf
authors.forename: Avis
authors.initials: A
authors.lastname: Yount
mesh_terms: D000438:Alcohols / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006204:Hair Removal; D006801:Humans; D007466:Iodophors / Q000627:therapeutic use*; D011300:Preoperative Care; D012867:Skin / Q000382:microbiology; D058257:Surgical Attire; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000438:Alcohols; D000891:Anti-Infective Agents, Local; D007466:Iodophors; C010882:chlorhexidine gluconate; D002710:Chlorhexidine