Rethinking Skin Preparation: Is Hypochlorous Acid (Clinisept+) a Safe Alternative Skin Preparation in Aesthetic Surgery?

Ali Arnaout; Mohammad R Goodarzi; Nora F Nugent; Marc D Pacifico; Fulvio Urso-Baiarda; Charles A T Durrant; Simon Heppell; Ahmed S Ali-Khan

doi:10.1007/s00266-026-05806-2

Rethinking Skin Preparation: Is Hypochlorous Acid (Clinisept+) a Safe Alternative Skin Preparation in Aesthetic Surgery?

Aesthetic Plast Surg. 2026 Apr 20. doi: 10.1007/s00266-026-05806-2. Online ahead of print.

Authors

Ali Arnaout¹, Mohammad R Goodarzi², Nora F Nugent³, Marc D Pacifico³, Fulvio Urso-Baiarda⁴, Charles A T Durrant⁵, Simon Heppell⁵, Ahmed S Ali-Khan⁶

Affiliations

¹ LASE Cosmetic, Newcastle, UK.
² Royal Victoria Infirmary, Newcastle, UK.
³ Purity Bridge, Tunbridge Wells, UK.
⁴ Berkshire Grove Hospital, Maidenhead, UK.
⁵ Adnova Clinic, Fareham, UK.
⁶ LASE Cosmetic, Jesmond, Newcastle, UK. info@lasecosmetic.com.

PMID: 42009924
DOI: 10.1007/s00266-026-05806-2

Abstract

Background: Surgical site infections (SSIs) in aesthetic surgery, though rare (~1%), can compromise outcomes. Standard preoperative antiseptics such as chlorhexidine gluconate (CHG) and povidone-iodine are effective but may cause irritation or toxicity. Clinisept+ is a stabilised hypochlorous acid (HOCl) solution with broad antimicrobial activity and excellent tissue compatibility, yet evidence for its surgical use is limited.

Methods: A prospective, multicentre audit was conducted in four UK private aesthetic surgery clinics (January-August 2024). All patients received Clinisept+ as the sole preoperative skin preparation. Demographics, smoking status, procedure type, antibiotic prophylaxis, SSIs, wound complications, and skin reactions were recorded. SSIs were defined as infections requiring treatment. Associations with smoking and antibiotic use were analysed with Fisher's exact test.

Results: A total of 157 patients (median age 45 years; 78% female) underwent diverse aesthetic procedures. The SSI rate was 1.27% (2/157), both minor and resolving with oral antibiotics. All SSIs occurred in smokers without prophylactic antibiotics (p = 0.04 vs non-smokers). Wound-healing complications occurred in 5.1% (8/157), none infected. No skin sensitivity or allergic reactions were reported.

Conclusions: Clinisept+ yielded SSI rates comparable to historical data for CHG and povidone-iodine, with excellent tolerability and no observed skin irritation. HOCl-based preparation may be advantageous in patients with sensitive skin or when operating near mucosal or delicate regions. These findings support its safe use in aesthetic surgery, though randomised controlled trials are warranted to confirm non-inferiority.

Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords: Aesthetic surgery; Clinisept+; Hypochlorous acid; Skin antisepsis; Surgical site infection; Wound healing.