Bathing with 2% chlorhexidine gluconate versus routine care for preventing surgical site infections after pancreatic surgery: a single-centre randomized controlled trial

Clin Microbiol Infect. 2025 May;31(5):825-831. doi: 10.1016/j.cmi.2025.01.004. Epub 2025 Jan 11.

Abstract

Objectives: The study aims to investigate whether bathing with 2% chlorhexidine gluconate (CHG) reduces the incidence of surgical site infection (SSI) in patients undergoing routine pancreatic surgery.

Methods: A randomized controlled trial was conducted at a large-volume pancreatic centre between 1 January 2021 and 31 December 2022. Patients undergoing clean-contaminated pancreatic surgery were enrolled and randomized into an intervention arm (bathing with a 2% CHG wipe) and a control arm (routine care, soap, and water). The primary outcome was the incidence of SSI after pancreatic surgery within 30 days.

Results: Overall, 614 patients (intervention arm, 311; control arm, 303) were included in intention-to-treat analysis. In total, 8.8% (54/614) patients developed SSI. The incidence of SSI in the intervention arm was 6.8% (21/311) and 10.9% (33/303) in control arm, and the difference did not reach the level of statistical significance (p 0.070). The time to SSI was significantly extended when patients were in the intervention arm (log-rank test, p 0.047). The intervention did not significantly reduce the incidence of healthcare-associated infection, hospital-acquired pneumonia, and bloodstream infection. No adverse events were observed. However, in the per-protocol analysis among 519 patients, the intervention arm showed a significantly lower incidence of overall SSI than that of those in the control arm (21/272, 7.7% vs. 33/242, 13.4%, p 0.036).

Discussion: Bathing with 2% CHG could potentially reduce the incidence of SSI for the patients scheduled to undergo pancreatic surgery for which further well-designed clinical trials are warranted.

Keywords: Bathing; Chlorhexidine gluconate; Pancreatic surgery; Randomized controlled trial; Surgical site infection.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anti-Infective Agents, Local* / administration & dosage
  • Baths* / methods
  • Chlorhexidine* / administration & dosage
  • Chlorhexidine* / analogs & derivatives
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pancreas* / surgery
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / prevention & control

Substances

  • Anti-Infective Agents, Local
  • Chlorhexidine
  • chlorhexidine gluconate