Rationale: Skin preparation products are used prior to surgery to quickly eliminate a wide range of microbes and provide a continuously high level of antimicrobial action for an extended duration of time.

Technology Description: Skin preparation products are used prior to surgery to quickly eliminate a wide range of microbes and provide a continuously high level of antimicrobial action for an extended duration of time. The most common skin preparation agents currently used in the United States for antisepsis prior to surgery are products that contain iodophors or chlorhexidine gluconate (CHG).

Controversy: Iodophors have been the standard topical antiseptic agents used to cleanse the skin prior to surgery. CHG is a newer antiseptic agent that has antimicrobial advantages over iodophors. It has not been determined which agent is the most effective at preventing surgical site infections (SSIs). In addition, these antiseptic agents may be in either aqueous- or alcohol-based solutions, which may further enhance their antiseptic properties.

Key Questions:

  • Is CHG effective in reducing the incidence of SSIs in adults undergoing clean, clean-contaminated, or contaminated surgery?
  • How does CHG compare with iodophors in reducing the incidence of SSIs?
  • Are topical CHG and iodophor products safe in adults who are undergoing surgery?
  • Have definitive patient selection criteria for topical CHG products been established?

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