Dr. Alexandra Webb Co-authors Important Skin Cleanser Study

January 2010

Dr. Alexandra Webb co-authored the study "Chlorhexidine – Alcohol versus Povidone – Iodine for Surgical-Site Antisepsis," published in the January 7, 2010, issue of the New England Journal of Medicine. The study was a randomized clinical trial conducted between April 2004 and May 2008 at six university-affiliated hospitals across the U.S., including the Atlanta Veterans Affairs Medical Center, where Dr. Webb is chief of general surgery. The study found that cleansing a patient's skin prior to surgery with chlorhexidine alcohol rather than with the more commonly used povidone iodine proved to be a more effective and powerful barrier to reducing or preventing infections after surgery. These findings are significant, as hospitals and health care providers are continuously striving to reduce and eliminate surgical site infections in patients.

A total of 897 patients were randomly assigned to a study group: 431 to the chlorhexidine-alcohol group and 466 to the povidone-iodine group. Of the 849 patients who qualified for the intention-to-treat analysis, 409 received chlorhexidine alcohol and 440 received povidone iodine. Dr. Webb and the team found that using chlorhexidine as the preoperative skin cleanser reduced infections by 41 percent compared with povidone iodine.

"This is an example of research that directly impacts the quality of patient care," says Dr. Chris Larsen. "A reduction of the surgical site infections of this magnitude would greatly reduce morbidity and have a major economic impact for hospitals, patients, and employers around the country."

More than 27 million surgical procedures are performed each year in the United States. According to the Centers for Disease Control and Prevention, there are approximately 1.7 million health care-associated infections each year in U.S. hospitals. Of these infections, 22 percent (or about 400,000) are surgical site infections, which result in longer hospital stays, readmission or sometimes death.