Enturia

Why Skin Prep Matters

According to the Centers for Disease Control and Prevention (CDC), 1.7 million people per year acquire an HAI, which results in 99,000 deaths — the equivalent of 271 people each day.¹ HAIs cause more deaths annually than AIDS, breast cancer, and auto accident deaths combined.²

Bloodstream infections (BSIs) and surgical site infections (SSIs) represent 36% of all HAIs.¹ To prevent these deadly infections, it is important to understand why "skin is the source" and what steps you can take to reduce your risk before surgery or a medical procedure.

Skin is the primary source of infection

Microorganisms on patients’ skin are the primary cause of SSIs and BSIs.⁵ Risks for infection increase when skin is incised or punctured during surgical procedures or catheter placements.

• 80% of microorganisms reside in the first five cell layers of the epidermis³
• Pathogenic or normal resident flora are major causes of BSIs and SSIs⁴
• Skin colonization at the insertion site and the migration of microorganisms into the body during catheter placement are primary risk factors for catheter-related bloodstream infections(CRBSIs)⁴
• Skin-dwelling microorganisms on the patient are primary risk factors for SSIs⁴

There is an increased prevalence of “super bugs”

Adherence to infection control guidelines and proper antisepsis is critical for the reduction of antibiotic-resistant microorganisms.

• Super bugs such as Methicillin-Resistant Staphylococcus aureus (MRSA) resist traditional antibiotic treatment. Incidences of MRSA increased from 22% of total staph infections in 1995 to about 63% in 2004, according to the CDC
• Super bugs often require treatment with second- or third-line agents, which may be less effective and have higher toxicity compared to first-line agents
• Coagulase-negative Staphylococci can form biofilm and attach to catheters and other implanted medical devices, forming virulent strains of bacteria⁵

CHG is a preferred antimicrobial agent⁶

Use of Chloraprep for patient preoperative skin preparation helps reduce microorganisms on patients’ skin.

Ideal properties for an antimicrobial agent:⁷

• Broad spectrum
• Rapid bactericidal activity
• Residual properties on the skin
• Active in the presence of organic matter
• Low allergic or toxic responses
• None or minimal systemic absorption

Comparison of Antimicrobial Agents
Active Agents	Traditional Iodophors	Alcohol	Chlorhexidine
Broad Spectrum	X	X	X
Rapid Activity		X
Residual Activity			X
Activity in Blood/Organic Matter			X
Non/Minimal Absorption			X

ChloraPrep formulation demonstrates superior antimicrobial action

ChloraPrep combines 2% chlorhexidine gluconate (CHG) and 70% isopropyl alcohol (IPA) and provides two distinct mechanisms of action:

• IPA: Rapidly kills microorganisms by denaturing cell proteins
• CHG: Maintains persistent antimicrobial activity by disrupting the cell membrane and precipitating cell contents

Delivery device

• ChloraPrep single-use applicators eliminate direct hand-to-patient contact, helping prevent cross-contamination
• The gentle-friction scrub allows the solution to penetrate the first five cell layers of the epidermis to reduce skin-dwelling microorganisms

Additional benefits of the ChloraPrep system

• Broad spectrum: ChloraPrep antimicrobial activity is effective against microorganisms including gram-positive and gram-negative bacteria, Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-Resistant Enterococci (VRE), Clostridium difficile, Acineobacter, and most viruses and fungi ^7,8,9
• Active in protein-rich biomaterials: Remains active in the presence of blood, serum and other protein-rich biomaterials^8,10 unlike traditional iodophors, which are neutralized¹¹
• Low irritation: CHG demonstrates low incidence of irritation⁸

Clinical studies support 2% CHG as a preferred antimicrobial

• Efficacy of 2% CHG in 70% IPA solution
  Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant

• SSI prevention
  Efficacy of surgical preparation solutions in foot and ankle surgery

• CRBSI prevention
  Prevention of infections related to central venous catheters and arterial catheters in intensive care patients

Additional clinical studies for 2% CHG
Review more than 30 additional clinical studies that support the use of a 2% CHG & CHG–based formula for patient preoperative skin preparation.