Is it time to rethink your skin preparation?

Wong J, Williams N

Abstract

Surgical site infection (SSI) is a recognised operative complication which may prolong length of hospital admission, unplanned readmissions, and increased clinical and economic burden in the setting of in and outpatient settings. Preoperative skin disinfection is known to eliminate skin microflora and prevent the occurrence of SSI. This is routinely performed before the operation.

Chlorxhexidine (CH) and povidone-iodine (PI) are known preoperative skin antisepsis used in surgical settings. Mostly hospitals including Wagga Wagga Rural Referral Hospital mostly use PI skin preparations routinely for surgery.

There is increasing evidence recently that demonstrates the chlorhexidine based pre-operative skin preparation is associated with lower incidence of surgical sites infections in clean and clean-contaminated surgeries compared to iodine based skin preparations.(1,2,3,) Meanwhile, no significant differences in the adverse events recorded. (1,2,3)

This emerging evidence suggest it is perhaps time for us to rethink our choice of skin antisepsis.