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I N F E C T I O N
P R E V E N T I O N
hol prep was more effective than a 0.7% iodine and 74% isopropyl alcohol or a 3% chloroxylenol formulation.6 Povidone-iodine (in gel form and in 7.5% and 10% formulations) were "not sufficient in eliminating pathogens in foot and ankle surgery."7
• For shoulder surgeries, a 2% CHG, 70% isopropyl alcohol prep was more effective in overall bacteria elimination when compared to an 0.7% iodine, 74% alcohol combination and 7.5% or 10% povidoneiodine.8
• In open hernia repairs, a chlorhexidine-ethanol preparation and povidone-iodine produced comparable reductions in skin flora bacteria at the site.9
Regarding surgical site infection rates:
• In addition to their similarly significant antibacterial effects, the chlorhexidine-ethanol preparation and povidone-iodine also delivered comparable reductions in SSIs following open hernia repairs.9
• CHG alone (in 0.5% or 4% formulations) and CHG (2%, 4% and 0.5%) with 70% isopropyl alcohol bested povidone-iodine in reducing SSI rates following clean-contaminated surgeries.10-15
• The 2% CHG, 70% alcohol prep was found to be superior to povidone-iodine in preventing SSIs in clean-contaminated surgeries.16
Implications and iodine
The immediate practice implications for our nursing staff were clear. The collected research recommended chlorhexidine gluconate with isopropyl alcohol for pre-surgical skin prepping because of the high antibacterial efficacy and surgical site reduction rates the combination demonstrated in abdominal, groin, foot, ankle, shoulder and clean-contaminated surgeries.
That's not to say we've dumped the rest of our skin prep supplies down the drain. CHG plus alcohol may deliver a one-two punch to
