In contrast to the situation with skin preparation for intravascular catheters, there have been no recommendations for surgical practice. A randomised controlled trial compared chlorhexidine–alcohol (2% chlorhexidine gluconate and 70% isopropyl alcohol or ‘ChloraPrep’) with povidone–iodine in 849 patients undergoing surgery. The overall rate of surgical-site infection was significantly lower in the chlorhexidine–alcohol group than in the povidone–iodine group (9.5% vs. 16.1%) and chlorhexidine–alcohol was significantly more protective than povidone–iodine against both superficial incisional infections (4.2% vs. 8.6%) and deep incisional infections (1% vs. 3%) but not against organ-space infections (4.4% vs. 4.5%)
Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis
N Engl J Med. 2010 Jan 7;362(1):18-26