Evidence for Using Chlorhexidine Gluconate Preoperative Cleansing to Reduce the Risk of Surgical Site Infection

AORN Journal

Volumn 92, Issue 5, 2010, Pages 509-518

  Edmiston, Charles E ^a   Okoli, Obi ^a   Graham, Mary Beth ^a   Sinski, Sharon ^b   Seabrook, Gary R ^a  

^a MEDICAL COLLEGE OF WISCONSIN   (United States)

^b FROEDTERT MEMORIAL LUTHERAN HOSPITAL   (United States)

Author keywords

Chlorhexidine gluconate; Health care associated infection; Preoperative cleansing; Preoperative shower; Skin antisepsis; Surgical site infection

Indexed keywords

CHLORHEXIDINE; CHLORHEXIDINE GLUCONATE; DRUG DERIVATIVE; TOPICAL ANTIINFECTIVE AGENT;

ARTICLE; EVIDENCE BASED MEDICINE; HUMAN; PREOPERATIVE CARE; RISK FACTOR; SAFETY; SURGICAL INFECTION; TREATMENT OUTCOME;

ANTI-INFECTIVE AGENTS, LOCAL; CHLORHEXIDINE; EVIDENCE-BASED MEDICINE; HUMANS; PREOPERATIVE CARE; RISK FACTORS; SAFETY MANAGEMENT; SURGICAL WOUND INFECTION; TREATMENT OUTCOME;

EID: 78049241602     PISSN: 00012092     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.aorn.2010.01.020     Document Type: Article

References (41)

1. Zhan C., Miller M.R. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA 2003, 290(14):1868-1874.
2. Webster J., Osborne S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev 2007, [review], Issue 2. Art No:CD004985COI:10.1002/14651858.CD004985.pub3.
3. Fisher R.B. The antiseptic principle. Joseph Lister 1977, 121-157. Stein and Day, New York, NY.
4. Tentative final monograph for healthcare antiseptic drug products: proposed rules. 21 CRF Parts 333 and 369. Fed Regist Part III 1994, 59:31401-31452. US Food and Drug Administration.
5. Holder C., Zellinger M. Daily bathing with chlorhexidine in the ICU to prevent central line-associated infections. J Clin Outcome Manage 2009, 16(11):509-513.
6. Keser A., Bozkurt M., Taner O.F., Yorgancigil B., Dogan M., Sensoz O. Evaluation of antiseptic use in plastic and hand surgery. Ann Plast Surg 2005, 55(5):490-494.
7. Genuit T., Bochicchio G., Napolitano L.M., McCarter R.J., Roghman M.C. Prophylactic oral rinse decreases ventilator-associated pneumonia in surgical ICU patients. Surg Infect 2001, 2(1):5-18.
8. Goldenberg R.L., McClure E.M., Saleem S., Rouse D., Vermund S. Use of vaginally administered chlorhexidine during labor to improve pregnancy. Obstet Gynecol 2006, 107(5):1139-1146.
9. Rouse D.J., Hauth J.C., Andrews W., Mills B.B., Maher J.E. Chlorhexidine vaginal irrigation for the prevention of peripartal infection: a placebo-controlled randomized clinical trial. Am J Obstet Gynecol 1997, 176(3):617-622.
10. Culligan P.J., Kubik K., Murphy M., Blackwell L., Snyder J. A randomized trial that compared povione iodine and chlorhexidine as antiseptics for vaginal hysterectomy. Am J Obstet Gynecol 2005, 192(2):422-425.
11. Milstone A.M., Passaretti C.L., Perl T.M. Chlorhexidine: expanding the armamentarium for infection control and prevention. Clin Infect Dis 2008, 46(2):274-281.
12. Edmiston C.E., Seabrook G.R., Johnson C.P., Paulson D.S., Beausoleil C. Comparative of a new and innovative 2% chlorhexidine gluconate-impregnated cloth with 4% chlorhexidine glucoate as topical antiseptic for preparation of the skin prior to surgery. Am J Infect Control 2007, 35(2):89-96.
13. McDonnell G., Russell A.D. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999, 12(1):147-179.
14. Barry A.L., Fuch P.C., Brown S.D. Lack of effect of antibiotic resistance on susceptibility of microorganisms to chlorhexidine gluconate or povidone iodine. Diagn Microbiol Infect Dis 1999, 18(12):920-921.
15. Wang J.T., Sheng W.H., Wand J.L., et al. Longitudinal analysis of chlorhexidine susceptibities of nosocomial methicillin-resistant Staphylococcus aureus isolates at a teaching hospital in Taiwan. J Antimicrob Chemother 2008, 62(3):514-517.
16. Edmiston C.E., Krepel C.J., Seabrook G.R., Lewis B.D., Brown K.R., Towne J.B. Preoperative shower revisited: can high topical antiseptic levels be achieved on the skin surface prior to surgical admission?. J Am Coll Surg 2008, 207(2):233-239.
17. Rosenberg A., Alatary S.D., Peterson A.F. Safety and efficacy of the antiseptic chlorhexidine gluconate. Surg Gynecol Obstet 1978, 143(5):789-792.
18. Henschen A., Olson L. Chlorhexidine-induced degeneration of adrenergic nerves. Acta Neuropathol 1984, 63(1):18-23.
19. Kinirons B., Mimoz O., Lafendi L., Naas T., Meunier J., Nordmann P. Chlorhexidine versus povidone iodine in preventing colonization of continuous epidural catheters in children: a randomized, controlled trial. Anesthesiology 2001, 94(2):239-244.
20. Grewal S., Hocking G., Wildsmith J.A. Epidural abscesses. Br J Anesthesiol 2006, 96(3):292-302.
21. Hamed L.M., Ellis F.D., Boudreault G., Wilson F.M., Helveston E.M. Hibiclens keratitis. Am J Ophthalmol 1987, 104(1):50-56.
22. Phinney R.B., Modino B.J., Hofbauer J.D., et al. Corneal edema related to accidental Hibiclens exposure. Am J Ophthalmol 1988, 106(2):210-215.
23. Earnshaw J.J., Berridge D.C., Slack R.C., Makin G.S., Hopkinson B.R. Do preoperative chlorhexidine baths reduce the risk of infection after vascular reconstruction?. Eur J Vasc Surg 1989, 3(4):323-326.
24. Hayek L.J., Emerson J.M. Preoperative whole body disinfection-a controlled clinical study. J Hosp Infect 1988, 11(suppl B):15-19.
25. Wihlborg O. The effect of washing with chlorhexidine soap on wound infection rate in general surgery. A controlled clinical study. Ann Chir Gynaecol 1987, 76(5):263-265.
26. Randall P.E., Ganguli L Marcuson R.W. Wound infection following vasectomy. Br J Urol 1983, 55(5):564-567.
27. Rotter M.L., Larsen S.O., Cooke E.M., et al. A comparison of the effects of preoperative whole-body bathing with detergent alone and with detergent containing chlorhexidine gluconate on the frequency of would infections after clean surgery. The European Working Party on Control of Hospital Infections. J Hosp Infect 1988, 11(4):310-320.
28. Ostrander R.V., Botte M.J., Brage M.E. Efficacy of surgical preparation solutions in foot and ankle surgery. J Bone Joint Surg Am 2005, 87(5):980-985.
29. Saltzman M.D., Nuber G.W., Gryzlo S.M., Marecek G.S., Koh J.L. Efficacy of surgical preparation solutions in shoulder surgery. J Bone Joint Surg Am 2009, 91(8):1949-1953.
30. Kaiser A.B., Kernodle D.S., Barg N.L., Petracek M.R. Influence of preoperative showers on staphylococcal skin colonization: a comparative trial of antiseptic skin cleansers. Ann Thorac Surg 1988, 45(1):35-38.
31. Garibaldi R.A., Skolnick D., Lerer T., et al. The impact of preoperative skin disinfection on preventing intraoperative wound contamination. Infect Control Hosp Epidemiol 1988, 9(3):109-113.
32. Magera J.S., Inman B.A., Elliott D.S. Does preoperative topical antimicrobial scrub reduce positive surgical site culture rates in men undergoing artificial urinary sphincter placement. J Urol 2007, 178(4pt1):1328-1332.
33. Popovich K.J., Hota B., Hayes R., Weinstein R.A., Harden M.K. Effectiveness of routine patient cleansing with chlorhexidine gluconate for infection prevention in the medical intensive care unit. Infect Control Hosp Epidemiol 2009, 30(10):959-963.
34. Bleasdale S.C., Trick W., Gonzalez I.M., Lyles R.D., Hayden M.K., Weinstein R.A. Effectiveness of chlorhexidine bathing to reduce catheter-associated bloodstream infections in medical intensive care unit patients. Arch Intern Med 2007, 167(19):2073-2079.
35. Munoz-Price L.A., Hota B., Stemer A., Weinstein R.A. Prevention of bloodstream infections by use of a daily chlorhexidine bath for patients at a long-term acute care hospital. Infect Control Hosp Epidemiol 2009, 30(11):1031-1035.
36. Eiselt D. Presurgical skin preparation with a novel 2% chlorhexidine gluconate cloth reduces rates of surgical site infection in orthopaedic surgical patients. Orthop Nurs 2009, 28(3):141-145.
37. Mangram A.J., Horan T.C., Pearson M.L., Silver L.C., Jarvis W.R. Guidelines for the prevention of surgical site infections, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1999, 27(2):97-132.
38. Recommended practices for preoperative patient skin antisepsis. Preoperative Standards and Recommended Practices 2010, 351-369. AORN, Inc, Denver, CO.
39. Pottinger J.M., Starks S.E., Steelman V.M. Skin reparations. Periop Nurs Clin 2006, 1(3):203-210.
40. Pastor C., Artinya A., Varma M.G., Gibbs L., Garcia-Aguilar J. An increase in compliance with Surgical Care Improvement Project measures does not prevent surgical site infection in colorectal surgery. Dis Colon Rectum 2010, 53(1):24-30.
41. Stulberg J.J., Delany C.P., Neuhauser D.V., Aron D.C., Fu P., Koroukian S.M. Adherence to Surgical Care Improvement Project measures and the association with postoperative infections. JAMA 2010, 303(24):2479-2485.