Chlorhexidine (CHG) wipes are pre-moistened cloths infused with an antiseptic solution, primarily used for cleaning the skin and reducing the number of germs. They apply the powerful antimicrobial agent chlorhexidine gluconate. These wipes are commonly employed in healthcare settings, such as hospitals and clinics, and are also given to patients for use at home to prepare for medical procedures. Their convenience and efficacy make them a popular product for infection control.
The Mechanism of Action
The active ingredient is chlorhexidine gluconate, a positively charged molecule known as a cationic bisbiguanide antiseptic. This positive charge gives it a strong germ-killing ability, as it is attracted to the negatively charged outer surfaces of microbial cells, including bacteria and some fungi. Chlorhexidine binds to the cell wall, disrupting its structure and altering the osmotic balance. This action quickly kills the microorganisms on contact, providing an immediate sanitizing effect.
Chlorhexidine is recognized for a property called substantivity, allowing it to bind to the skin and remain active over a sustained period. After application, the antiseptic is slowly released from the skin’s surface, providing a lasting layer of protection. This protection continues to suppress the growth of resident skin flora for up to 48 hours. This residual activity is an advantage over other antiseptics, making it highly effective for prolonged infection prevention.
Primary Medical Applications
Chlorhexidine wipes are primarily used to reduce the risk of healthcare-associated infections (HAIs) in medical environments. The most common application is pre-surgical skin preparation, where patients use the wipes the night before and the morning of an operation. This regimen significantly lowers the bacterial load on the skin, reducing the chance of developing a surgical site infection.
Another frequent use is for daily patient bathing, particularly in intensive care units (ICUs), where patients are at a higher risk of infection. Daily bathing with CHG wipes reduces the spread of difficult-to-treat organisms like methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). This practice is a standard part of infection control protocols in hospitals.
The wipes are also used to clean the skin around insertion sites for medical devices, such as central venous catheters (CVADs). Keeping the skin at these entry points clean is important because bacteria can travel along the line and cause a bloodstream infection.
Step-by-Step Instructions for Use
Proper technique ensures the wipes function effectively, particularly when preparing for a medical procedure. If showering before use, the skin must be completely dry and cool before applying the antiseptic wipe; a waiting period of at least one hour after a shower is often recommended. Users should tear open the packet and unfold the towelette, then wipe the body from the neck down, avoiding the face and head.
Application should use firm, overlapping strokes to ensure the entire skin surface is saturated with the solution. Use a separate, fresh wipe for different body sections, such as the neck, chest, and abdomen, or both arms. After wiping, the skin must not be rinsed or towel-dried. The solution needs to air dry completely, which may take about one minute, and the skin may feel slightly sticky until it is fully dry.
Important Safety Precautions
Chlorhexidine wipes are strictly for external use and should never be swallowed. Avoid sensitive areas like the eyes, ears, mouth, and any internal genital or anal areas. If the solution gets in the eyes, which can cause irritation, the area should be flushed thoroughly with water.
Though rare, there is a risk of a serious allergic reaction to chlorhexidine, including anaphylaxis. Signs of a rash, redness, itching, or difficulty breathing require immediate medical attention. The product should not be used on broken, irritated, or open wounds unless directed by a healthcare professional, as it can impede wound healing. Wipes containing alcohol should be stored away from open flames due to flammability.