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The number of times and the number of days in advance that patients
should bathe before surgery to reach the optimal antiseptic effect
remain open questions.
This summer the Association of periOperative Registered Nurses
revised its recommendations on the matter to read, "The patient should
be instructed to bathe or shower before surgery with either soap or a
skin antiseptic on at least the night before or the day of surgery." While
an AORN infection preventionist admitted that the guidance was slight-
ly vague, she noted conflicting evidence on the practice.
In contrast, the Institute for Healthcare Improvement's Project
JOINTS initiative to reduce SSIs after hip and knee replacement sur-
geries advised 3 days' worth of chlorhexidine gluconate showers back
in 2013. The institute's recommendation cited CHG's cumulative effect
against skin-based bacteria and a study showing that while 3 days of
showers had a greater impact than just 1 day, 5 days was not any
more effective than 3 days.
There is, however, a practical logic to recommending a middle path
of 2 antiseptic showers, the night before and the morning of, says
Cindy Williams, surgical services coordinator at the Medical
Development Corporation in Hudson, Fla. "This way we know they
will do it at least once."
Which product do you recommend patients use?
• CHG liquid soap: 45.8%
• We don't specify a particular product: 18.1%
• CHG wipes: 10.2%
• Household bath soap: 9%
• An antiseptic skin prep solution: 2.4%
• Other: 14.5%
P R E - O P B A T H I N G
