Darouiche RO, Wall MJ Jr, Itani KM, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med. 2010;362:18-26.
Bode LG, Kluytmans JA, Wertheim HF, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010;362:9-17.
Findings from two landmark studies on reducing surgical-site infections (SSIs) are reported in the January 7, 2010 issue of the New England Journal of Medicine.
The first study examined the benefits of using a mix of the chemical antiseptic chlorhexidine and alcohol for preoperative skin cleansing. In this evaluation, researchers randomly allocated 849 patients, scheduled for clean-contaminated surgery in six hospitals, to be prepped with either the chlorhexidine-alcohol scrub or a scrub and paint with traditionally used povidone-iodine. In the first chlorhexidine-alcohol group, the rate of post-op infection was only 9.5%, as opposed to 16.1% in the povidone-iodine group.
The second study enlisted 808 people who tested positive for Staphylococcus aureus, and underwent a surgical procedure that required hospitalization for at least 4 days. These patients were randomly designated to receive nasal decolonization with mupirocin ointment and skin decolonization with chlorhexidine, or placebo. In the study group, 3.4% of the patients got a S. aureus infection, versus 7.7% in the placebo group. Although chlorhexidine and alcohol is not indicated for use in every surgery, these studies show this combination is more effective in reducing SSIs than povidone-iodine.