Decolonization of the Skin of the Patient and Surgeon

Objective: To review the evidence regarding antisepsis and decolonization of the skin of the patient and surgeon for the prevention of surgical site infection (SSI). Data Sources: General bibliographic and specialist computer databases, along with manual searching of reference lists of primary and review articles, were used to search for relevant peer-reviewed citations. Results: Antisepsis of the surgical site and of the hands of the surgeon is a mainstay in the prevention of SSI. Waterless and scrubless alcohol-based products are an alternative to traditional antiseptic scrubs. Chlorhexidine-based products for skin preparation at the surgical site have proved superior to other preparation products for bacterial decolonization. The efficacy of routine preoperative decolonization strategies, including the use of nasal mupirocin ointment and antiseptic body washes, has not been established definitively by randomized clinical trials. Conclusions: Antisepsis of the skin of patient and surgeon are important in the prevention of SSI. Preoperative decolonization strategies for prevention of SSI, particularly those caused by antibiotic-resistant organisms, remain controversial. Division of Acute Care Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan.