CHG's been around for a long time. If you look at the wealth of data
out there, it has a tremendous capacity for microbial kill. The drug is
very, very effective. I'm a big believer in evidence, and there's no
doubt in my mind that the use of an antiseptic agent, from a scientific
and a pragmatic perspective, is an effective intervention in reducing
microbial flora. My role is to continue looking at the science and
developing interventions for patients and procedures, and my col-
leagues and I are publishing a rebuttal to the updated guidelines in a
clinical journal this spring.
Q: Are there other recommendations we should be looking to for
direction on pre-op patient skin antisepsis?
A: There's a growing body of research that views antiseptic skin
preparation as a key component of "surgical care bundles" to prevent
SSIs. Combining evidence-based individual interventions will reduce
risk, the research suggests. For example, while the antiseptic shower
reduces microbial flora on the skin, additional evidence-based interven-
tions such as nasal swabbing for MRSA and Staph aureus surveillance,
pre-op antibiotics and antimicrobial closures limit other infection risks.
A 2014 study by University of Michigan researchers (tinyurl.com/kboa-
jyh) found that applying a surgical bundle of 6 interventions to colorec-
tal surgery patients reduced the post-op infection rate from 18% to 2%.
The subtraction of 1 or more interventions from the regimen, though,
showed a decline in the results. What we're trying to figure out now is,
what plays the primary role in reduction, and which interventions pro-
vide an optimal fit to which patient populations?
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | February 2015
There's no doubt in my mind that the
use of an antiseptic agent is an effective
intervention in reducing microbial flora.
— Charles Edmiston Jr., PhD, CIC
