DR TIM SANDLE considers best practice in the use of chlorhexidine skin disinfection, prior to surgery, with the aim of reducing the risk of surgical site infection.
The application of a cutaneous solution for disinfection of the intact skin is part of good surgical practice prior to any invasive procedures taking place. This includes pre-operative skin disinfection. Disinfection is undertaken through the use of a skin disinfectant (commonly termed an antiseptic).1 Antiseptics can be classified as bactericidal (capable of killing most members of a population of microorganisms) or bacteriostatic (capable to inhibiting the growth of members of a population of microorganisms). In general, bactericidal products are preferred.
The correct application of a suitable antiseptic is necessary to minimise the risk of surgical site infection. This class of infection accounts for about 15% of all healthcare-associated infections in total and about 37% of the hospital-acquired infections of surgical patients.2, 3
The ideal antiseptic agent should be effective against a wide range of microorganisms; work within a fast onset of action; exert a long-term effect; and not be readily inactivated by organic material (e.g. blood). Moreover, it should have minimal toxic effects on the skin. For pre-operative surgery, the most commonly used antiseptic is the skin disinfectant chlorhexidine. Chlorhexidine is well-established in the clinical field. It was discovered in 1946 and introduced into clinical practice in 1954. Today, chlorhexidine is probably the most widely used antiseptic in the world.4
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