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

Surgical site infections (SSIs) in aesthetic surgery, though rare (~1%), can compromise outcomes. Standard preoperative antiseptics such as chlorhexidine gluconate (CHG) and povidone-iodine are effective but may cause irritation or toxicity. Clinisept+ is a stabilised hypochlorous acid (HOCl) solution with broad antimicrobial activity and excellent tissue compatibility, yet evidence for its surgical use is limited.

A prospective, multicentre audit was conducted in four UK private aesthetic surgery clinics (January-August 2024). All patients received Clinisept+ as the sole preoperative skin preparation. Demographics, smoking status, procedure type, antibiotic prophylaxis, SSIs, wound complications, and skin reactions were recorded. SSIs were defined as infections requiring treatment. Associations with smoking and antibiotic use were analysed with Fisher's exact test.

A total of 157 patients (median age 45 years; 78% female) underwent diverse aesthetic procedures. The SSI rate was 1.27% (2/157), both minor and resolving with oral antibiotics. All SSIs occurred in smokers without prophylactic antibiotics (p = 0.04 vs non-smokers). Wound-healing complications occurred in 5.1% (8/157), none infected. No skin sensitivity or allergic reactions were reported.

Clinisept+ yielded SSI rates comparable to historical data for CHG and povidone-iodine, with excellent tolerability and no observed skin irritation. HOCl-based preparation may be advantageous in patients with sensitive skin or when operating near mucosal or delicate regions. These findings support its safe use in aesthetic surgery, though randomised controlled trials are warranted to confirm non-inferiority.

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