Full-Body Versus Local Wipe Disinfection With Chlorhexidine Gluconate: No Difference in Surgical Site Infection After Acute Hip Fracture Surgery.

Abstract

Preoperative skin disinfection is essential to reduce surgical site infection. This study compared full body with local skin disinfection and examined additional patient related factors that could influence surgical site infection. This non-randomized intervention study, conducted over two consecutive periods, included patients with a hip fracture who received preoperative full-body disinfection with 4% chlorhexidine gluconate or local skin disinfection of the hip using 2% chlorhexidine gluconate, with 90 days follow up. Postoperative dressing change was documented. 844 patients were included in the study; 556 (65.7%) patients were treated with full body disinfection and 288 patients (34.1%) with local wipes disinfection. Fourteen patients (1.7%) suffered from a surgical site infection, eleven patients in the full body disinfection group, and three patients with local wipes disinfection without any significant difference found between the groups. Seven (50%) patients with infection had the dressing changed < 48 h. Chronic kidney disease was significantly associated with local infection (p = 0.005). Local preoperative skin disinfection with a washcloth showed no increased risk of wound infection in patients with hip fracture compared to full body disinfection, indicating comparable effectiveness. Impaired kidney function may increase susceptibility. Documentation gaps highlight the need to evaluate adherence to dressing routines to strengthen postoperative wound care. Chlorhexidine gluconate, Full body skin disinfection, Hip fracture, Local wipes disinfection, Surgical site infection.