Preoperative skin antisepsis – it ain’t what you do but the way that you do it

In 2010, the New England Journal of Medicine published a randomized controlled trial (RCT) which reported the use of preoperative skin antisepsis using 2% chlorhexidine gluconate/70% isopropyl-alcohol (applied with a disposable, purpose-built, sponge applicator and a “scrubbing” technique), or an aqueous 10% povidone-iodine based preparation (applied as a paint), for prevention of surgical site infection (SSI)1. Thirty-nine of 409 patients in the 2% CHG/70% IPA study arm (9.5%) and 71 of 440 patients in the 10% PVP-I study arm (16.1%) developed an SSI after clean and clean-contaminated abdominal procedures (RR = 0.59; 95% CI: 0.41 – 0.85; P=0.004).