Wednesday, September 2, 2015

Chlorhexidine Bathing- The Saga Continues

Here is an article on pre-surgical chlorhexidine bathing that it of interest. The abstract can be accessed here.

The authors conducted a randomized prospective analysis in 120 healthy volunteers was conducted using a standardized process of dose, duration, and timing of 4% chlorhexidine gluconate applied during preoperative showering. The volunteers were randomized to 2 chlorhexidine gluconate, 4%, showering groups (2 vs 3 showers), containing 60 participants each, and 3 subgroups (no pause, 1-minute pause, or 2-minute pause before rinsing), containing 20 participants each. Volunteers used 118 mL of chlorhexidine gluconate, 4%, for each shower. Skin surface concentrations of chlorhexidine gluconate were analyzed.

The findings? 

A standardized preadmission shower regimen that includes 118 mL of aqueous chlorhexidine gluconate, 4%, per shower, with a minimum of 2 sequential showers; and a 1-minute pause before rinsing results in maximal skin surface concentrations of chlorhexidine gluconate. This concentration  (16.5 µg/cm2) is sufficient to inhibit or kill potential surgical wound pathogens.

Although surgical infection outcomes were not assessed, the findings suggest that pre-operative chlorhexidine bathing must be formalized and clearly protocolized with easy to use instructions in order to result in adequate antibacterial effect. 

This remains a work in progress.

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