Does the use of chlorhexidine gel reduce the frequency of surgical site infections?

<b>Introduction:</b> Surgical site infections (SSI) involve 2-11% of all surgical procedures. <br><b>Paper assumption:</b> The use of 6% gel with chlorhexidine as an element of preoperative skin preparation of the operated area reduces the number of surgical site infections. <br><b>Aim:</b> The aim of the study was to assess the impact of body mass index (BMI), neutrophil to lymphocyte ratio (NLR), total protein, glucose, length of hospitalization before surgery, duration of surgery, length of drainage maintenance, transfusion of red blood concentrate on the number of SSI. <br><b>Materials and methods:</b> 248 patients were subjected to prospective analysis. Patients were operated at the Department of General and Oncological Surgery of the Provincial Specialist Hospital in Zgierz. Patients were divided into three groups depending on the microbiological degree of cleanliness of the postoperative wound: Group I - clean wounds, Group II - cleancontaminated wounds, Group III - contaminated wounds, which also included emergency surgerical procedures. In each group two subgroups were distinguished depending on the method of preoperative preparation of the surgical field: A - gel without CHG, B - 6% gel with CHG. <br><b>Results:</b> Surgical site infections were found in 22 patients (8.9%). The respective frequencies for groups I, II, III are: 3.0% vs 12.9% vs 12.7%. An increase in NLR by one unit resulted in a higher incidence of surgical site infections by 11%. A transfusion of RBC to the patient resulted in a 3.5-fold increase in the frequency of surgical site infections. Extending the drain maintenance time by one day increases the SSI frequency by 41%. Lowering the total protein concentration by at least 1 g/dl below normal increases the risk of surgical site infections almost three times. <br><b>Conclusions:</b> The use of a 6% gel preparation with chlorhexidine as an element of preoperative preparation of the surgical field reduces the risk of surgical site infections, especially in clean-contaminated and contaminated wounds.

Surgical site infections - review of current knowledge, methods of prevention.

This paper presentes the current state of konwledge regarding the everlasting problem in surgery- surgical site infections. INTRODUCTION: Surgical site infections have accompanied humanity since the dawn of time. Development of medicinie has reduced their percentage, but still they are a huge problem to face with. Surgical site infections cause a significant increase in a cost of hospitalization. This is the main reason why the whole scientific world is looking for prevention of these complications. MATERIALS AND METHODS: The aim of the paper is to present current views on the etiology and methods of prevention of surgical site infection. RESULTS: Patients own pathogens are most often responsible for surgical site infections. In hospitalizations over 5-7 days exogenous and hospital flora have the advantage. The most common isolated pathogen is Staphylococcus aureus. The percentage of MRSA-resistant methicillin strains is increasing. Pre-operative antibiotic therapy reduces the frequency of surgical site infection in many surgical procedures. Time of administration, type and dose of antibiotic play an important role in preventing post-operative infections. Pre-operative skin antiseptic is also important. The two most commonly used ingredients are chlorhexidine gluconate and povidone iodine. Recent reports point the chlorhexidine alcohol solution as an agent with a higher degree of efficacy. CONCLUSIONS: In 2017 Centers for Disease Control and Prevention published the new guidelines for prevention of surgical site infections. This practical tips and tricks should be implemented to every surgical procedure.