Presurgical skin preparation with a novel 2% chlorhexidine gluconate cloth reduces rates of surgical site infection in orthopaedic surgical patients

Orthop Nurs. 2009 May-Jun;28(3):141-5. doi: 10.1097/NOR.0b013e3181a469db.


Background: Postoperative surgical site infections (SSIs) are a common complication of joint surgery. Prevention depends on adequate preoperative skin antisepsis. In previous studies, use of a 2% chlorhexidine gluconate (CHG) no-rinse cloth reduced SSI rates in general surgery patients.

Methods: Patients admitted for a total joint procedure used a skin antisepsis protocol incorporating 2% CHG no-rinse cloths to do a site-specific wash on the night before surgery and in the holding area just before surgery.

Results: In the 3 quarters before implementation of the protocol, the SSI rate was 3.19%. In the 3 quarters after the 2% CHG cloth was introduced, the SSI rate decreased to 1.59%, representing a 50.16% reduction in SSIs.

Conclusions: The rate of SSI was cut in half after the introduction of 2% CHG no-rinse cloths in the place of a povidone-iodine (Betadine) skin antiseptic in orthopaedic patients undergoing total joint procedures. Further testing using randomization comparative protocols are required to conclude that the decreased SSI was in fact a direct result of the 2% CHG protocol.

MeSH terms

  • Administration, Topical
  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use*
  • Chlorhexidine / administration & dosage
  • Chlorhexidine / analogs & derivatives*
  • Humans
  • Orthopedics*
  • Preoperative Care
  • Surgical Wound Infection / prevention & control*


  • Anti-Infective Agents, Local
  • chlorhexidine gluconate
  • Chlorhexidine