No Clear Benefit of Chlorhexidine Use at Home Before Surgical Preparation.

TitleNo Clear Benefit of Chlorhexidine Use at Home Before Surgical Preparation.
Publication TypeJournal Article
Year of Publication2018
AuthorsMakhni MChugh, Jegede K, Lombardi J, Whittier S, Gorroochurn P, Lehman RA, K Riew D
JournalJ Am Acad Orthop Surg
Volume26
Issue2
Paginatione39-e47
Date Published2018 Jan 15
ISSN1940-5480
KeywordsAdministration, Cutaneous, Adolescent, Adult, Aged, Aged, 80 and over, Anti-Infective Agents, Local, Chlorhexidine, Female, Healthy Volunteers, Humans, Male, Middle Aged, Neck, Outcome Assessment, Health Care, Preoperative Care, Prospective Studies, Skin, Surgical Wound Infection, Young Adult
Abstract

INTRODUCTION: Several studies have evaluated the efficacy of home use of chlorhexidine before surgery to reduce bacterial colonization. However, these studies have provided conflicting evidence about the potential efficacy of this strategy in decreasing bacterial loads and infection rates across surgical populations, and no prior study has analyzed the benefit of this intervention before spine surgery. We prospectively analyzed the effectiveness of chlorhexidine gluconate wipes for decreasing bacterial counts on the posterior neck.

METHODS: Sixteen healthy adults participated in this prospective study. The right side of each participant's neck was wiped twice (the night before and the morning of the experiment) with chlorhexidine gluconate wipes. The left side was used as the control region. Bacterial swabs were obtained as a baseline upon enrollment in the study, then upon arrival at the hospital, and, finally, after both sides of the neck had received standard preoperative scrubbing.

RESULTS: All patients had positive baseline bacterial growth (median >1,000 colonies/mL). When chlorhexidine gluconate wipes were used, decreased bacterial counts were noted before the preoperative scrub, but this finding was not statistically significant (P = 0.059). All patients had zero bacteria identified on either side of their neck after completion of the preoperative scrub.

CONCLUSION: At-home use of chlorhexidine gluconate wipes did not decrease the topical bacterial burden. Therefore, using chlorhexidine gluconate wipes at home before surgery may offer no added benefit.

DOI10.5435/JAAOS-D-16-00866
Alternate JournalJ Am Acad Orthop Surg
PubMed ID29227322
PubMed Central IDPMC5768234