Cleaning surgical sites during post-op period

[JustcallmeNurse]

Hi Everyone,

I am in a residency program where we have to do an EBP research project at completion. I am doing my project on surgical site infection and whether or not using Chlorhexidine for washing of surgical sites during the post-op period is still EBP. I am having a hard time finding research on this but I can find many things on what prep is done peri-op. So my questions are: At your facility do you do daily or per shift washing of surgical sites? Do you do it with Chlorhexidine or something different? Do you have any evidence for why your facility uses what they use?

Please note that I am not looking for someone to do my "homework" for me, but am looking for what you currently do at your facility.

Thanks in advance!

[icuRNmaggie, BSN, RN]

Great topic.

I read an article about five years ago in a wound care journal which said that the use of chlorhexidine on a surgical incision impairs healing by destroying keratanocytes.

The chlorhexidine applied in the OR before the incision should be left on for five days to deter infection but not reapplied.

Ask any surgeon, soap and water is the best disinfectant for the periwound area and cleanse the healing incision with saline on a 4x4, pat dry. Let it heal naturally.

Even with a sternotomy it's shower with soap and water, using a fresh facecloth for the chest area.

Painting post op incisions with chlorhexidine has never been EBP to the best of my knowledge.

I would be very interested in reading something more current; please post your findings. Good luck with your project and your residency.

[JustcallmeNurse]

Thanks icuRNmaggie for the information! I'll post things up as I find them.

[JWG223]

Hi Everyone,

I am in a residency program where we have to do an EBP research project at completion. I am doing my project on surgical site infection and whether or not using Chlorhexidine for washing of surgical sites during the post-op period is still EBP. I am having a hard time finding research on this but I can find many things on what prep is done peri-op. So my questions are: At your facility do you do daily or per shift washing of surgical sites? Do you do it with Chlorhexidine or something different? Do you have any evidence for why your facility uses what they use?

Please note that I am not looking for someone to do my "homework" for me, but am looking for what you currently do at your facility.

Thanks in advance!

We perform CHG baths as a matter of course on most patients. By policy, we do one at least every 24 hours on any patient with any sort of central line. Allegedly, this has shown a decrease in infections at line sites. We must be doing something correctly, as we have had virtually none for the last 2 years between our ICU and SDU.

I do not have any input as relates directly to surgical site care, though, sadly.

[icuRNmaggie, BSN, RN]

The chlorhexidine bath wipes are 2%. Chloraprep is 4% chlorhexidine. I may have misunderstood the OP. I have read that painting an incision with chloraprep impairs healing. I was not referring to the bath wipes.

[Here.I.Stand, BSN, RN]

I haven't read the research articles myself, but we do daily CHG baths (the pre-moistened wipes) in the ICU. But I was taught that they NOT be used on face, genital/perianal area, or on open skin.