Evaluation with a focus on both the antimicrobial efficacy and cumulative skin irritation potential of chlorhexidine gluconate alcohol–containing preoperative skin preparations

Background Important characteristics for ideal skin preparations include long-lasting antimicrobial efficacy and low potential for skin irritation. Methods A total of 55 healthy adult subjects were enrolled to evaluate the antimicrobial effects of 3 test formulations applied to inguinal, abdominal, and antecubital sites at post-treatment time points of 30 seconds, 72 hours, and 7 days. To investigate skin irritation potential, the 3 formulations were tested in a 21-day repeat-insult patch test conducted on the skin of the backs of 23 healthy subjects. Results The mean log 10 reduction (MLR) at 7 days post-treatment produced by a 79% vol/vol ethanol containing 1% wt/vol chlorhexidine gluconate (1% CHG-EtOH) applied to abdominal sites was significantly superior to that produced by a 10% povidone-iodine solution (2.45 MLR vs 0.90 MLR; P P  > .05). Conclusion Considering its persistent effect and low skin irritation potential, the 1% CHG-EtOH preparation is expected to perform well in surgical site preparation to reduce the risk of surgery- and catheter-related bloodstream infection.