Chlorhexidine Cloth Overview for Surgical Infection Prevention

Abstract

Infections are one of the most devastating complications that occur after lower extremity total joint arthroplasty or any surgical procedure. As such, it has become a major priority to reduce them through various preoperative strategies. Popular prophylactic antimicrobials include alcohol-based solutions, povidone iodine, as well as combinations of chlorhexidine-based products to address an individual’s microbial load on the skin. Chlorhexidine is a broad-spectrum biocide with activity against Gram-positive and Gram-negative bacteria. The use of chlorhexidine cloths may be a choice over solutions, since some studies have shown that they can reduce lower extremity infection rates by greater than two-thirds. In this report, we will describe the scientific basis for the dual application technique of these cloths, as well as our general recommendations for usage for lower extremity arthroplasties and other surgical procedures. Multiple studies have demonstrated their efficacy, with a prospective randomized study of joint arthroplasties demonstrating a 2.9% deep infection rate without their use versus a reduction to 0.4%. In conclusion, we believe that these cloths are appropriate for use in all hip and knee lower extremity arthroplasties as well as other surgical procedures.