ChloraPrep Allergies?

[Marie_LPN, RN, LPN, RN]

Recently (appx. 3 months ago), one of our orthopod groups decided to switch to ChloraPrep for all of their Duraprep-prep cases, after reading an article on its effectiveness. But they're noticing that most of the pts. coming back for their post-op visit have had post-op allergic skin reactions, and so far it seems like the ChloraPrep is doing it (the Ioban, Xeroform gauze, Scarlet Red, and latex were ruled out).

Haven't heard from the company that makes ChloraPrep yet (sent the sales rep an email a few days ago), but that's still in the works. Meanwhile, i put Duraprep back on their preference sheets, and Chloraprep is only used on their cases when there's a betadine allergy.

Has anyone else had this issue with ChloraPrep in any surgical or nursing specialty?

[TracyB,RN, RN]

We're in the process of switching over to Chlora-Prep. Last week used it & thought the guy was developing a hive, showed the surgeon, who disagreed. I used to work for an allergist so I've seen lots of hives, but anyway, the patient was fine during surgery. Didn't hear of any problems afterwards.

I wonder if the problems are stemming from the Chlora-Prep staying in contact with the skin TOO long, since that stuff is beastly to remove.

Our rep said that the only people who should have a problem with reactions are those who are allergic to green #6 (?) food dye & that color was chosen b/c of the extremely low rate of that.

I don't like how it leaks out of the opposite end of the sponge & recovery nurses don't like it b/c of checking cap refill on extremities.

[Marie_LPN, RN, LPN, RN]

The company has a clear and orange version of ChloraPrep also. We're getting the same problems from the clear, green/blue, and the orange.

[TracyB,RN, RN]

Hmmm.... Have you heard back from the rep yet? I glanced at the website briefly & couldn't find any info on reactions. Even checked the MSDS on the site to see what the inactive ingredients are. No luck there, either.

It's mostly your ortho docs using it? Any other services? We have been using the clear for quite some time for perm-cath insertions, but nothing else really & no complaints that we get to hear about.

We only have the green & clear.

Rep recommended to go over, say toes or fingers, to remove the colored solution. Supposedly, going over the color with the clear helps to remove the color from nailbeds... sounds like a money maker to me, LOL.

I've been sick with upper respiratory issues the past 2 days, so I haven't been able to talk with anyone at work about this. Hopefully, this fever breaks & the non-stop coughing stop so I can stop using this stupid nebulizer Q4 & get back to work. I'm BORED!!!!!

[EricJRN, MSN, RN]

We use ChloraPrep for some things in the NICU (like blood cultures) but our babies rarely have allergic responses to anything. I do notice that when you break the seal, only one side of the sponge seems to be wet.

[ewattsjt]

We were in the process of switching over to chloraprep and the docs didn't like it. It seemed to irritate the skin if it all wasn't removed vs. dura prep mainly irritating tender areas. Another problem that we encountered is that in long procedures such as multi level spine cases; the ioban quits sticking to chloraprepped areas before the end of the case.

[Marie_LPN, RN, LPN, RN]

Hmmm.... Have you heard back from the rep yet?

Nope. He's never been known for prompt attention. :stone

I glanced at the website briefly & couldn't find any info on reactions. Even checked the MSDS on the site to see what the inactive ingredients are. No luck there, either.

I know, that's why i contacted the rep next. The website's kinda vague on this.

It's mostly your ortho docs using it? Any other services? We have been using the clear for quite some time for perm-cath insertions, but nothing else really & no complaints that we get to hear about.

Our vascular docs were using the green, clear, and orange for their access cases, and ironically, they have no reactions reported on any of those cases. The gernal docs are using CloraPrep though (all colors) and are getting the same issue that my ortho docs are.

The gyn docs didn't want to switch, so they're still using DuraPrep.

One of the things i went over with the ortho docs (boy that was a fun meeting, not) was about their pre-op orders for site prep. We have two that want the operative sites washed with BetaSept the morning of surgery, so i thought maybe the 'double cleaning' was making the skin extra sensitive. But the same kind of skin reaction are happening with the pts. that aren't getting a pre-op scrub.

I've been sick with upper respiratory issues the past 2 days, so I haven't been able to talk with anyone at work about this. Hopefully, this fever breaks & the non-stop coughing stop so I can stop using this stupid nebulizer Q4 & get back to work. I'm BORED!!!!!

Ew, sounds like the same stuff everyone i work with is passing around. Take care of yourself.:smilecoffeecup:

[Marie_LPN, RN, LPN, RN]

We were in the process of switching over to chloraprep and the docs didn't like it. It seemed to irritate the skin if it all wasn't removed vs. dura prep mainly irritating tender areas. Another problem that we encountered is that in long procedures such as multi level spine cases; the ioban quits sticking to chloraprepped areas before the end of the case.

That's why one of our ortho docs refuses to use ChloraPrep on his total joint cases. The Ioban started peeling back less than 20 minutes into the case.

[akasha2211]

I recently had day surgery and had an extensive reaction to the chloraprep (i.e. red raised rash everywhere the prep was used which started approx. 36 hours post-op). The rash, although resolving, is still visible nearly 2 weeks post-op. Fortunately, I have no allergy to iodine, so I'll ask for betadine should I ever again need surgery.

I'm wondering if there may be a greater incidence of reaction (or more severe reaction) in individuals with other allergies. I have severe allergies to several antibiotics, as well as latex and am wondering if any of you are aware of a relationship between such allergies and reaction to chloraprep.

Thanks.

[otiscokat]

It isn't real common, but I am allergic to the active ingredient in Chloraprep. It would be weird if all the ortho pts. were allergic. About 2/3 of our docs use it with no problems, that I have heard about.

[retired1988]

I found out I was sensitive to this prep and it made for great discomfort after insertion of mammosite catheter into my breast. The insertion site and the internal breast felt on fire and itched the evening after insertion. I was miserable for two days with sense of pressure and discomfort inside the breast. day 3 the pressure finally lessened. Thank goodness I had remaining percocet from the lumpectomy to deal with the pain. Ended up being more painful than the stereotatic biopsy and the lumpectomy plus sentinel node biopsy. I wish they would have used betadine.

If time permits, patients to undergo procedures need to have skin tested for sensitivity in the doctor office before the procedure. Help make sure not to make an unpleasant experience even more unpleasant. I will insist on this before any other invasive procedure.

[TraciBdarn]

VERY interesting thread...

We were led to believe that chloroprep wouldn't cause this type of reaction...

lots of questions.. but I'll sit on them for now