Chlorhexidine reduces infections in knee arthroplasty

The purpose of this study was to evaluate the incidence of surgical site infections in total knee arthroplasty patients using a preadmission cutaneous skin preparation protocol compared with a cohort of patients undergoing standard in-hospital perioperative preparation only. Records between 2007 and 2010 were reviewed to identify deep incisional and periprosthetic infections among patients using the chlorhexidine protocol (478 patients) and patients who did not use the protocol (1,735 patients). Patients using the chlorhexidine cloths were given two packets of six chlorhexidine gluconate-impregnated cloths, with instructions for use, the evening before and morning of surgery. A statistically lower incidence of surgical site infection was found in patients using the chlorhexidine cloths (0.6%) compared with patients undergoing in-hospital perioperative skin preparation only (2.2%). On the basis of the results of this study, a preadmission chlorhexidine protocol seems to be an effective method to prevent surgical site infections in total knee arthroplasty procedures.