Total body bathing with ‘Hibiscrub’ (chlorhexidine) in surgical patients: a controlled trial

Total body bathing with ‘Hibiscrub’ (chlorhexidine-detergent) solution was compared with non-medicated soap in 224 patients admitted for surgery. Some 9·6 per cent of patients were found to be nasal carriers of Staphylococcus aureus on admission but 17·3 per cent were colonized at some time during their inpatient stay. Skin colonization by Staph. aureus was only seen in four patients (2 per cent), three were cleared by ‘Hibiscrub’ bathing but carriage persisted in the other patient who used non-medicated soap. A greater reduction in the total bacterial count on the skin and in the perianal region was seen in patients using ‘Hibiscrub’. An increase in the bacterial count was frequently seen in patients using non-medicated soap. Post-operative staphylococcal wound infection occurred in nine patients (4·0 per cent) but nasal or skin carriage was only present in two patients. Although there was no difference in the rates of infection using ‘Hibiscrub’ or ordinary soap, pre-operative bathing with ‘Hibiscrub’ may be beneficial as there is a greater reduction in the total bacterial count. The use of non-medicated soap is of dubious value and may even increase the numbers of bacteria on the skin.