Effects of whole body disinfection on skin flora in patients undergoing elective surgery

Bacterial skin flora were studied in two groups of patients having three showers with either a 4% chlorhexidine detergent solution (Group A, N = 57) or a placebo detergent (Group B, N = 58). Previous reports on the efficacy of chlorhexidine in decreasing bacterial counts on the skin were confirmed and the time taken to recolonization (median 5 days; range 1-10 days) was in broad agreement with previous reports. However, concern regarding the colonization of the skin of the patients in the chlorhexidine group by potential pathogens during the recolonization period appears unfounded as there was no significant difference in the incidence of non-resident skin flora between the chlorhexidine (17/57; 30%) and the placebo (14/58; 24%) groups. These non-residents are generally lost from the skin before discharge in the chlorhexidine group but nine patients in the placebo group had abnormal skin flora at discharge from hospital. All those patients tested after discharge had lost the non-resident flora within 2 weeks of discharge. The results of this study indicate that recolonization of the skin after whole body disinfection does not present a clinical problem.