Presurgical Skin Preparation With a Novel 2% Chlorhexidine Gluconate Cloth Reduces Rates of Surgical Site Infection in Orthopaedic Surgical Patients

BACKGROUND: Postoperative surgical site infections (SSIs) are a common complication of joint surgery. Prevention depends on adequate preoperative skin antisepsis. In previous studies, use of a 2% chlorhexidine gluconate (CHG) no-rinse cloth reduced SSI rates in general surgery patients. METHODS: Patients admitted for a total joint procedure used a skin antisepsis protocol incorporating 2% CHG no-rinse cloths to do a site-specific wash on the night before surgery and in the holding area just before surgery. RESULTS: In the 3 quarters before implementation of the protocol, the SSI rate was 3.19%. In the 3 quarters after the 2% CHG cloth was introduced, the SSI rate decreased to 1.59%, representing a 50.16% reduction in SSIs. CONCLUSIONS: The rate of SSI was cut in half after the introduction of 2% CHG no-rinse cloths in the place of a povidone-iodine (Betadine) skin antiseptic in orthopaedic patients undergoing total joint procedures. Further testing using randomization comparative protocols are required to conclude that the decreased SSI was in fact a direct result of the 2% CHG protocol.