What's the best way to use CHG for patients before surgery?

Findings from a study recently published in JAMA Surgery provide a standardized way for patients to bathe with chlorhexidine gluconate prior to surgery that optimizes skin surface concentrations of CHG.

Researchers conducted an analysis of 120 patients who were randomized into two main groups and two subgroups. The two main groups showered with 118mL of 4 percent CHG either two or three times. The subgroups either did not pause, paused for one minute or paused for two minutes prior to rinsing.

After the showers, skin surface concentrations of CHG were analyzed from five parts of the body.

They found that the people who paused either one or two minutes had significantly higher CHG concentrations when compared to the no-pause group. There was no significant difference in concentrations for people who took either two or three showers, and no significant difference between the one-minute pause group and the two-minute pause group.

Therefore, the researchers suggest that hospitals should use the following standard in pre-op bathing to achieve optimum CHG concentrations on the skin:

  • 118 mL of 4 percent CHG
  • Minimum of two sequential showers
  • One-minute pause before rinsing

"This showering regimen corrects deficiencies present in current nonstandardized preadmission shower protocols for patients undergoing elective surgery," the study concludes.

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