Clean & clear

Your guide to ingredients in pre-operative cleansers

Introduction

Clinical decisions about patient surgical preparation should always follow local protocols, approved product information and institutional requirements.
However, understanding the differences between whole-body cleansing approaches can help healthcare professionals evaluate the practical and clinical considerations associated with each option, including:
- How effective are the active ingredients?
- Is the protocol easy to follow?
- How does the evidence compare?
Take a look at the pros and cons of different protocols below. If you require any additional information, our experts are here to help.

Talk to our experts

Need more information about pre-surgery cleansing? Complete the form and one of our experts will be in touch.

CHG (Chlorhexidine Gluconate)

CHG is one of the most widely used antiseptic agents for preoperative whole-body cleansing. Valued for its broad-spectrum antimicrobial activity and residual effect on the skin, it is often incorporated into patient preparation protocols.

Although protocols typically require at least two applications prior to surgery, and patient compliance should be considered, it is a well-evidenced option with a strong foundation of microbiological and clinical data supporting its use.

Maintains antimicrobial performance in the presence of organic material^1,2,3,4
Extended antimicrobial action demonstrated across the broad evidence base^?
43% of patients show no bacterial growth post-shower⁵

PVI (Povidone Iodine)

Povidone Iodine has a long history of use in infection prevention, and offers broad antimicrobial coverage. Factors such as application protocols, persistence of activity and the strength of supporting evidence may influence its suitability.

Long-established antiseptic with broad microbial coverage
Single-application protocols support patient compliance
Antimicrobial activity strongly inhibited by blood, pus, fat and glove powder³

OCT (Octenidine Dihydrochloride)

Octenidine-based cleansers are a newer option in some preoperative preparation pathways, offering broad antimicrobial activity and skin tolerability.

Growing interest in their use has led to an emerging evidence base, although familiarity, protocol adoption and comparative clinical data may vary between healthcare settings. Currently, evidence comes mainly from individual studies focused on Staphylococcus aureus reduction.

Broad spectrum antimicrobial activity with good skin tolerability^?
Individual studies show associations with reduced S. aureus colonisation^?
Application protocol usually spread across 5+ days

Soap & Water

Soap and water is a simple, accessible approach to preoperative cleansing and is often used where antiseptic products are not indicated or preferred.

However, it can be less effective at reducing skin microbial burden in comparison to antiseptic-based alternatives, and in some cases has been found to spread bacteria, rather than eliminate it.

Simple, traditional cleansing method with easy compliance
May leave soil behind and increase bacterial release⁷
Only 5% of patients using medicated soap showed no bacterial growth post-wash⁵

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References

1. Block’s Disinfection, Sterilization and Preservation (sixth Edition) Gerald McDonnell and Joyce Hansen (2021). 
2. Aly R et al; Comparative evaluation of chlohexidine gluconate (Hibiclens) and povidone-iodine (E-Z scrub) Curr. Ther. Res. 1983; 34: 740-745 
3. Zamora et al (Not sure what source this is?) 
4. Preoperative whole body disinfection by shower bath with chlorhexidine soap: effect on transmission of bacteria from skin flora; Brandberg, Å. Et al. Maibach, HI & Aly, R (eds) Skin microbiology and its relevance to infection;1981:92–97
5. Garibaldi RA. Prevention of intraoperative wound contamination with chlorhexidine shower and scrub. Journal of Hospital Infection 1988; 11: 5-9. 
6. Clinical Evidence for the Use of Octenidine Dihydrochloride to Prevent Healthcare-Associated Infections and Decrease Staphylococcus aureus Carriage or Transmission—A Review - PMC 
7. Preoperative whole body disinfection by shower bath with chlorhexidine soap: effect on transmission of bacteria from skin flora; Brandberg, Å. Et al. Maibach, HI & Aly, R (eds) Skin microbiology and its relevance to infection;1981:92–97

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Your guide to ingredients in pre-operative cleansers

Introduction

Clinical decisions about patient surgical preparation should always follow local protocols, approved product information and institutional requirements.

How effective are the active ingredients?

Is the protocol easy to follow?

How does the evidence compare?

Talk to our experts

CHG (Chlorhexidine Gluconate)

Maintains antimicrobial performance in the presence of organic material^1,2,3,4

Extended antimicrobial action demonstrated across the broad evidence base^?

43% of patients show no bacterial growth post-shower⁵

PVI (Povidone Iodine)

Long-established antiseptic with broad microbial coverage

Single-application protocols support patient compliance

Antimicrobial activity strongly inhibited by blood, pus, fat and glove powder³

OCT (Octenidine Dihydrochloride)

Broad spectrum antimicrobial activity with good skin tolerability^?

Individual studies show associations with reduced S. aureus colonisation^?

Application protocol usually spread across 5+ days

Soap & Water

Simple, traditional cleansing method with easy compliance

May leave soil behind and increase bacterial release⁷

Only 5% of patients using medicated soap showed no bacterial growth post-wash⁵

Contact us

References

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Your guide to ingredients in pre-operative cleansers

Introduction

Clinical decisions about patient surgical preparation should always follow local protocols, approved product information and institutional requirements.

How effective are the active ingredients?

Is the protocol easy to follow?

How does the evidence compare?

Talk to our experts

CHG (Chlorhexidine Gluconate)

Maintains antimicrobial performance in the presence of organic material1,2,3,4

Extended antimicrobial action demonstrated across the broad evidence base?

43% of patients show no bacterial growth post-shower5

PVI (Povidone Iodine)

Long-established antiseptic with broad microbial coverage

Single-application protocols support patient compliance

Antimicrobial activity strongly inhibited by blood, pus, fat and glove powder3

OCT (Octenidine Dihydrochloride)

Broad spectrum antimicrobial activity with good skin tolerability?

Individual studies show associations with reduced S. aureus colonisation?

Application protocol usually spread across 5+ days

Soap & Water

Simple, traditional cleansing method with easy compliance

May leave soil behind and increase bacterial release7

Only 5% of patients using medicated soap showed no bacterial growth post-wash5

Contact us

References

Maintains antimicrobial performance in the presence of organic material^1,2,3,4

Extended antimicrobial action demonstrated across the broad evidence base^?

43% of patients show no bacterial growth post-shower⁵

Antimicrobial activity strongly inhibited by blood, pus, fat and glove powder³

Broad spectrum antimicrobial activity with good skin tolerability^?

Individual studies show associations with reduced S. aureus colonisation^?

May leave soil behind and increase bacterial release⁷

Only 5% of patients using medicated soap showed no bacterial growth post-wash⁵