To dilute or not to dilute

[PetiteOpRN]

I've been wondering about this for ages.

Every surgeon where I work has his or her own "signature" prep. Many use chlorhexidine gluconate at some point during the prep. Some insist that it must be diluted with water or NS to work correctly (as a detergent, it has to be mixed with water so that microorganisms are emulsified and solubalized and better removed from the skin). Others say that chlorhexidine gluconate cannot be diluted because it changes the chemical formula and it fails to kill microbes.

What do you see in your practice? Is there any evidence to support one argument or the other? (They both make sense to me)

[Rose_Queen, BSN, MSN, RN]

Check the manufacturer's recommendations. Can't go wrong with that, and then it's in writing to reinforce the proper way to use it. Don't have much experience with it because we use mostly chloraprep or betadine scrub/paint.

[Mr. & Mrs. RN]

I believe the packaging says not to dilute. AORN also recommends that you don't dilute.