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R E S E A R C H
R O U N D U P
(tinyurl.com/lcfpgjw).
• After reviewing 13 studies involving 2,623 participants and a variety of skin antiseptics, researchers at the University of York in England saw no statistically significant differences in SSI rates between skin-prepping agents and were inconclusive as to which was most effective, or whether pre-op preparations had any effect on post-op infections at all. Some studies showed alcohol-based products as having a high probability of effectiveness, but evidence quality was low, they wrote in the Cochrane Database of Systematic Reviews in March 2013 (tinyurl.com/ml7pmkn). "Practitioners may therefore elect to consider other characteristics such as costs and potential side effects when choosing between alternatives."
Pragmatic providers have pointed out that, clinical competition aside, there's still a role for povidone-iodine as well as CHG in prepping practices. For eye, ear, head and neck surgeries, on mucous membranes, iodine can go where CHG and alcohol can't.
Wipe out infections
The Institute for Healthcare Improvement's Project JOINTS, an educational effort that aimed to reduce SSIs following orthopedic procedures (tinyurl.com/
otmkt4w), recommended that patients bathe or shower with CHG soap for at least 3 days before their surgeries. CHG-impregnated wipes have made this preop preparation even more convenient, even if its effect is still up for debate.
Researchers concede that CHG showers reduce skin-based bacteria, but do they also reduce SSI rates? A literature review conducted at the Royal Brisbane and Women's Hospital in Australia casts doubt. Seven trials involving 10,157 participants saw no statistically significant differences in infection rates between patients washing up with 4% CHG and those using a placebo or bar soap. As in previous reviews, the authors found "no clear evidence of benefit for preoperative showering or bathing with chlorhexidine over other wash products, to reduce surgical site infection. Efforts to reduce the incidence of nosocomial
