Standardized approach for preop chlorhexidine showers reduces SSIs

There is universal agreement that a chlorhexidine gluconate, 2% or 4%, whole-body bath or shower will reduce bacterial colonization of the skin. However, there are no definitive data suggesting that this practice is effective in reducing postoperative surgical site infections (SSIs).

Researchers from the Medical College of Wisconsin, Milwaukee, examined the efficacy of a standardized preadmission shower protocol that optimizes skin surface concentrations of chlorhexidine gluconate and compared the findings with published studies on preoperative skin preparation.

The researchers found that a protocol of 118 mL of aqueous 4% chlorhexidine gluconate per shower; a minimum of two sequential showers; and a 1-minute pause before rinsing maximizes the benefit of the shower as an effective risk reduction strategy for SSIs. This process corrects deficiencies present in current nonstandardized preoperative shower protocols.

—Edmiston Jr C E, Lee C J, Krepel C J, et al. Evidence for a standardized preadmission showering regimen to achieve maximal antiseptic skin surface concentrations of chlorhexidine gluconate, 4%, in surgical patients. JAMA Surg. Published online August 26, 2015.

http://archsurg.jamanetwork.com/article.aspx?articleid=2429291