The Effect of Preoperative Chlorhexidine Gluconate Cleanse on Lower Extremity Surgical Site Infections: A Retrospective Cohort Study

Dermatol Surg. 2024 Mar 22. doi: 10.1097/DSS.0000000000004169. Online ahead of print.


Background: Lower extremity surgical sites are at an increased risk of wound infection following Mohs micrographic surgery.

Objective: To evaluate the rate of lower extremity surgical site infections following a 14-day regimen of preoperative 4% chlorhexidine gluconate (CHG) rinses and postoperative wound occlusion for 14 days.

Materials and methods: Retrospective data were collected from procedures performed by the senior author from January 2022 through June 2023. To meet inclusion, patients must have completed waist-down CHG soak and rinse for 14 days before surgery, including the day before surgery. In addition, the patient must have kept the dressing clean, dry, and intact until the postoperative appointment at 14 days.

Results: A total of 100 Mohs cases met inclusion criteria. Zero patients developed a surgical site infection.

Conclusion: Chlorhexidine gluconate preoperative rinsing and postoperative occlusion for 14 days may minimize the risk of wound infection. Although further research is indicated, an opportunity exists for the adoption of CHG into routine clinical practice in the outpatient dermatology setting.