Topical Antimicrobials and the Open Surgical Wound

Topical antiseptic and antibiotic agents have been used for the prevention of surgical site infections since Joseph Lister's original research on this subject. Although these agents are used extensively in clinical practice, evidence to support the use of topical antimicrobial agents remains limited.

The world literature on the use of antiseptic and antibiotic agents was evaluated to determine the current status of evidence to support the use of topical antimicrobial agents in the prevention of surgical site infections.

Although several techniques of using topical antibiotic solutions, powders, antibiotic gauzes, and beads have some evidence for validation, there are equal numbers of reports that have failed to show benefit. There is little evidence to support the use of antiseptic solutions in the prevention of infections at the surgical site.

Additional clinical trials are necessary to provide evidence to support any of the methods for using topical antimicrobial agents to present surgical site infections. Dilute antiseptic agents should be considered in future trials when antimicrobial activity can be identified without local toxicity.