Preoperative bathing or showering with skin antiseptics to prevent XXXX .

@entity1 @entity281 @entity1216 @entity5164
BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower incidence of @entity281 . OBJECTIVES: To review the evidence for preoperative bathing or showering with antiseptics for preventing hospital-acquired (nosocomial) surgical site infections. SEARCH METHODS: For this fifth update we searched the Cochrane Wounds Group Specialised Register (searched 18 December 2014); the Cochrane Central Register of Controlled Trials (The Cochrane Library 2014 Issue 11); Ovid MEDLINE (2012 to December Week 4 2014), Ovid MEDLINE (In-Process _ Other Non-Indexed Citations December 18, 2014); Ovid EMBASE (2012 to 2014 Week 51), EBSCO CINAHL (2012 to December 18 2014) and reference lists of articles. SELECTION CRITERIA: Randomised controlled trials comparing any antiseptic preparation used for preoperative full-body bathing or showering with non-antiseptic preparations in @entity1 undergoing surgery. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for selection, risk of bias and extracted data. Study authors were contacted for additional information. MAIN RESULTS: We did not identify any new trials for inclusion in this fifth update. Seven trials involving a total of 10,157 @entity1 were included. Four of the included trials had three comparison groups. The antiseptic used in all trials was 4% @entity5164 (Hibiscrub/Riohex). Three trials involving 7791 @entity1 compared @entity1216 with a placebo. Bathing with @entity1216 compared with placebo did not result in a statistically significant reduction in SSIs; the relative risk of SSI (RR) was 0.91 (95% confidence interval (CI) 0.80 to 1.04). When only trials of high quality were included in this comparison, the RR of SSI was 0.95 (95%CI 0.82 to 1.10). Three trials of 1443 @entity1 compared bar soap with @entity1216 ; when combined there was no difference in the risk of SSIs (RR 1.02, 95% CI 0.57 to 1.84). Three trials of 1192 @entity1 compared bathing with @entity1216 with no washing, one large study found a statistically significant difference in favour of bathing with @entity1216 (RR 0.36, 95%CI 0.17 to 0.79). The smaller studies found no difference between @entity1 who washed with @entity1216 and those who did not wash preoperatively. AUTHORS' CONCLUSIONS: This review provides no clear evidence of benefit for preoperative showering or bathing with @entity1216 over other wash products, to reduce @entity281 . Efforts to reduce the incidence of nosocomial @entity281 should focus on interventions where effect has been demonstrated.
