Study offers evaluation of residual chlorhexidine gluconate on skin

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Skin antisepsis is performed before surgery to minimize the risk of surgical site infections. Chlorhexidine gluconate (CHG) is routinely used in this application, but it may be removed during surgery when prepped areas are exposed to fluid and repeated blotting” Bashir et al (2018).

Summary:

Background: Skin antisepsis is performed before surgery to minimize the risk of surgical site infections. Chlorhexidine gluconate (CHG) is routinely used in this application, but it may be removed during surgery when prepped areas are exposed to fluid and repeated blotting.

Aim: This work evaluated the effect of adding a film-forming acrylate copolymer to a CHG-containing skin prep on minimizing CHG loss during a simulated surgical irrigation and wiping procedure. The results were compared to those obtained with a commercially available water-soluble CHG prep.

Methods: Two studies using excised porcine skin and one study on human volunteers were performed. In each study, the CHG preps were applied and the treated sites were challenged with repetitive saline soaks and gauze dabbing to simulate surgical conditions. Challenged and unchallenged sites were analyzed either for CHG contents by high-performance liquid chromatography, or for bacterial log recovery after seeding an indicator organism (reflecting remaining CHG activity).

Findings: After irrigation and wiping, skin treated with the film-forming CHG prep had more CHG remaining both on excised pig skin and in the human model. In the pig model, there was a lower recovery of inoculated bacteria with the CHG prep containing the film-forming copolymer. No skin irritation or adverse events were reported in the human study.

Conclusion: The addition of a film-forming copolymer has the potential to improve the retention of CHG on skin throughout a surgical procedure compared to a water-soluble prep. This improved retention may lead to better antimicrobial activity.

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Reference:

Bashir, M.H., Hollingsworth, A., Schwab, D., Prinsen, K.S., Paulson, J.E., Morse, D.J. and Bernatchez, S.F. (2018) Ex vivo and in vivo evaluation of residual chlorhexidine gluconate on skin following repetitive exposure to saline and wiping of 2% chlorhexidine gluconate/70% isopropyl alcohol preoperative skin preparations. The Journal of Hospital Infection. October 15th. .

DOI: https://doi.org/10.1016/j.jhin.2018.10.004

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