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The overall SSI rate was 9.5% in the chlorhexidine-alcohol group vs. 16.1% in the povidone-iodine group.
Both antiseptic agents possess broad-spectrum antimicrobial activity, but the researchers note that chlorhexidine-alcohol's superior protection is related to its more rapid action, residual effect and persistent activity despite exposure to bodily fluids. The study was funded by CareFusion, which makes both types of surgical prep.
Linda R. Greene, RN, MPS, CIC, manager of infection prevention at Highland Hospital in Rochester, N.Y., says her clinicians use chlorhexidine for most surgeries, particularly orthopedic and cardiac procedures. "Many clinicians have been waiting for robust evidence published in a reputable peer review jour-nal," she says. "This randomized control study provides evidence to support
the use of chlorhexidine."
The cost of chlorhexidine-alcohol is typically $7 to $10 per case, compared with less than $1 for a regular povidone-iodine paint, says Ms. Greene. She says chlorhexidine-alcohol is easy to use and quick-drying, but its application method is different than the typical prep. Rather than applying in concentric circles, it requires a back-and-forth scrubbing motion, she says. "Additionally," she says, "it cannot be used on mucus membranes because it contains alcohol, so there are limitations."
— Daniel Cook
