Effect of 2% Chlorhexidine Gluconate-Impregnated Cloth on Surgical Site Infections in Vascular Surgery.
BACKGROUND
Surgical site infections (SSIs) are a significant burden to patients and health care systems. This retrospective study evaluates the observed rates of SSI after our institution implemented chlorhexidine gluconate-impregnated (CHG) cloth as a preoperative antiseptic preparation in elective vascular surgery.


METHODS
Between March 2011 and January 2012, we reviewed 250 patients who underwent elective vascular surgery who used the CHG cloth preoperatively. Their rate of SSIs was compared with 252 control patients who received the CHG shower preoperatively during the preintervention period. Urgent and emergent cases were excluded. The primary outcome measured was SSI within 30 days of index operation.


RESULTS
There was no baseline difference in mean age, gender distribution, smoking status, diabetes, chronic obstructive pulmonary disease, and the number of patients with body mass index >40 between the cohorts. There was no difference in the overall rate (5.6% vs. 5.6%, P = 1.00) and type of SSIs between the 2 groups, but the control group trended toward deeper infections (4 deep incisional and 2 organ space vs. none and 1, respectively). The control group also had more dirty or infected wound categories (10 vs. 21.4%, P < 0.01) and more perioperative antibiotic errors and hypothermia (P < 0.02).


CONCLUSIONS
There was no observed difference in SSI rates before and after implementation of the CHG as the preoperative method of skin decontamination in our retrospective case-control cohorts.
University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: jsbak@wisc.edu.
John
J
Bak
Division of Vascular Surgery, Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, WI.
Jason
J
Le
Division of Vascular Surgery, Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, WI.
Toshio
T
Takayama
Division of General Surgery, Department of Surgery, University of Wisconsin Hospital and Clinic, Madison, WI.
Angela
A
Gibson
Division of Infectious Diseases, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI.
Sara
S
Zerbel
Division of Infectious Diseases, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI.
Nasia
N
Safdar
Division of Vascular Surgery, Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, WI.
Jon S
JS
Matsumura
D000279:Administration, Cutaneous; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003666:Decontamination / Q000379:methods*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D000891:Anti-Infective Agents, Local; C010882:chlorhexidine gluconate; D002710:Chlorhexidine