Rethinking Skin Preparation: Is Hypochlorous Acid (Clinisept+) a Safe Alternative Skin Preparation in Aesthetic...

Area of Science:

• Plastic Surgery
• Infectious Disease Control
• Dermatology

Background:

• Surgical site infections (SSIs) are rare but can impact aesthetic surgery outcomes.
• Standard antiseptics like chlorhexidine gluconate (CHG) and povidone-iodine carry risks of irritation or toxicity.
• Hypochlorous acid (HOCl) solutions offer broad antimicrobial activity and good tissue compatibility, but their use in surgery requires more evidence.

Purpose of the Study:

• To evaluate the efficacy and safety of Clinisept+ (HOCl) as a sole preoperative skin preparation in aesthetic surgery.
• To determine the surgical site infection (SSI) rate associated with Clinisept+ use.
• To assess wound complications and skin reactions following Clinisept+ application.

Main Methods:

• A prospective, multicentre audit involving 157 patients across four UK private aesthetic surgery clinics.
• Clinisept+ was used as the exclusive preoperative skin antiseptic for all participants.
• Data collected included demographics, smoking status, procedure type, antibiotic prophylaxis, SSIs, wound complications, and skin reactions. Statistical analysis used Fisher's exact test.

Main Results:

• The overall SSI rate was 1.27% (2/157), with both infections being minor and responsive to oral antibiotics.
• All SSIs occurred in smokers who did not receive prophylactic antibiotics (p=0.04 compared to non-smokers).
• Wound healing complications occurred in 5.1% of patients, with no associated infections. No skin sensitivity or allergic reactions were reported.

Conclusions:

• Clinisept+ demonstrated an SSI rate comparable to historical data for CHG and povidone-iodine in aesthetic surgery.
• The HOCl-based antiseptic exhibited excellent tolerability, with no reported skin irritation or adverse reactions.
• Clinisept+ may be a beneficial alternative for patients with sensitive skin or procedures near delicate areas, warranting further investigation through randomised controlled trials.