Preoperative washing with chlorhexidine gluconate and postoperative occlusion reduces postoperative wound infections: Study

A recent study found promising results in preventing infections in lower extremity surgical sites after Mohs micrographic surgery. The research focused on the effects of a 14-day regimen involving preoperative rinses with 4% chlorhexidine gluconate (CHG) and stringent postoperative wound care. The major findings of this study were published in the recent edition of Dermatologic Surgery journal.

Mohs micrographic surgery is renowned for its precision in removing skin cancers and often involves high stakes due to the complexity and location of the surgeries. Lower extremity sites are highly prone to infections due to various factors including poor blood supply and constant exposure to contaminants.

The study was conducted from January 2022 to June 2023 and meticulously gathered retrospective data from 100 cases that strictly adhered to the rigorous pre- and postoperative protocol. The criteria for inclusion in the study required patients to undertake a comprehensive waist-down soak and rinse with CHG for 14 days prior surgery to until the day before the operation. Also, the patients were instructed to keep the surgical dressing clean, dry and undisturbed until their follow-up appointment two weeks later.

These results revealed that none of the patients who followed this protocol developed any surgical site infections by indicating a potential breakthrough in postoperative care for Mohs surgery patients. These findings are particularly compelling given the current challenges in managing postoperative infections, which can complicate recovery processes, extend hospital stays and increase medical costs. The use of CHG which is a broad antiseptic that reduces bacteria significantly, could be a critical component in improving the patient outcomes following dermatological surgeries.

While the results of this study are encouraging, further research is necessary to fully ascertain the efficacy and safety of CHG in routine clinical practice. They advocate for additional studies to confirm these findings and potentially establish new standards of care that could be executed in outpatient dermatology settings nationwide.

This study paves the way for potentially integrating CHG rinses and meticulous wound care into standard pre- and postoperative routines but also highlights the importance of proactive infection control measures in surgical practices, specially in procedures that involved high-risk areas like the lower extremities. Overall, this research offers a promising perspective on preventing the complications through simple, yet effective, preoperative and postoperative care strategies.

Reference:

Dempsey, M. P., Riopelle, A. M., West, M., Kumar, A., & Schanbacher, C. F. (2024). The Effect of Preoperative Chlorhexidine Gluconate Cleanse on Lower Extremity Surgical Site Infections: A Retrospective Cohort Study. In Dermatologic Surgery. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/dss.0000000000004169