Preoperative Skin Antisepsis Guidelines

Introduction to Preoperative Skin Preparation

• The World Health Organization recommends using alcohol-based chlorhexidine solutions as the preferred agents for preoperative skin preparation, instead of clindamycin as a first-line agent 1, 2

Recommended Antiseptic Agents

• Chlorhexidine with alcohol (2.0-2.5% chlorhexidine in alcohol solution) is the preferred option for preoperative skin preparation 1
• Chlorhexidine solution (non-alcohol based) and povidone-iodine solution are alternative options for preoperative skin preparation 1

Application and Administration of Antiseptics

• Antiseptic should be applied within 60 minutes before skin incision 1
• For agents requiring longer administration time, begin administration within 120 minutes before incision 1
• Apply antiseptic solution thoroughly to the surgical site and allow sufficient drying time according to manufacturer's instructions 1

Additional Preoperative Measures

• For optimal results, use a fascial abdominal wound protector during surgery 1

Comprehensive SSI Prevention

• The World Health Organization recommends using alcohol-based chlorhexidine for skin preparation, administering appropriate systemic antibiotic prophylaxis, considering wound protectors for abdominal surgery, changing gloves and instruments before wound closure, and maintaining normothermia and controlling blood glucose during surgery 1
• The evidence strongly supports chlorhexidine-alcohol as the most effective preoperative skin antiseptic 1