Chlorhexidine gluconate (CHG) is a powerful antiseptic wash prescribed before certain surgical procedures. This special cleanser is designed to kill germs on the skin’s surface and reduce the overall microbial load. The primary purpose of using CHG before an operation is to significantly decrease the patient’s risk of developing a Surgical Site Infection (SSI). Following a healthcare team’s instructions for proper application is fundamental to ensuring the best possible outcome.
Why Chlorhexidine Gluconate is Necessary
CHG provides a level of skin disinfection that goes beyond what regular soap can achieve. Standard soaps primarily remove surface dirt and transient bacteria, but they do not actively kill a broad spectrum of microbes or provide prolonged protection. Chlorhexidine is a broad-spectrum biocide effective against gram-positive and gram-negative bacteria, as well as fungi.
The mechanism of action involves the positively charged CHG molecule binding to the negatively charged components of microbial cell walls, causing damage and leading to cell death. A unique property of CHG is its ability to bind to proteins in human skin, known as substantivity. This binding allows the antiseptic to persist on the skin and continue to provide antimicrobial activity for several hours after application. This persistence is important for maintaining a sterile surgical field during and after the procedure.
Proper CHG Application Steps
Preparation typically involves two showers: one the evening before surgery and one the morning of the procedure. Always follow specific instructions from your surgical team regarding the number of washes and timing. Before starting, remove all jewelry and nail polish. Also, avoid shaving the surgical site for at least two days prior to the procedure to prevent skin irritation.
The first step is to wash your hair and face using regular shampoo and soap, then rinse completely. Next, turn off the shower water to prevent the CHG from rinsing away prematurely. Apply the CHG solution to a clean washcloth or directly to your hands and begin washing your body from the neck down, avoiding the face and private areas.
Gently wash the entire body, paying special attention to the armpits, groin, and the planned surgical site. Allow the solution to remain in contact with the skin, lathered, for approximately two to five minutes. Following this contact time, turn the water back on and rinse the CHG thoroughly from your body with warm water.
After rinsing, do not use any regular soap, lotion, powder, deodorant, or perfume, as these products can interfere with the CHG’s residual activity. Pat your body dry with a fresh, clean towel and dress immediately in clean clothes or pajamas. Changing into clean sheets after the evening wash is also recommended to maintain a low microbial count on your skin.
Critical Safety Precautions
CHG is intended for external use only. Strict precautions must be taken to avoid contact with sensitive areas, including the eyes, ears, and mouth, as accidental contact can cause severe irritation or injury. If the antiseptic accidentally enters these areas, rinse promptly and thoroughly with water.
Do not apply the wash to open wounds, deep scrapes, or burns unless specifically instructed by a healthcare provider. Avoid using CHG on the genital or anal area unless directed, and rinse immediately if contact occurs. While rare, a severe allergic reaction (anaphylaxis) is possible, with symptoms including wheezing, difficulty breathing, facial swelling, or hives. If any signs of a serious allergic reaction occur, stop using the product and seek medical attention immediately.