Do preoperative chlorhexidine baths reduce the risk of infection after vascular reconstruction?

Pathogenic organisms are frequently present on the skin of vascular patients and are a risk factor for postoperative infection. A randomised trial of preoperative antiseptic baths was performed in 64 high risk vascular patients to determine whether two chlorhexidine baths could reduce the incidence of postoperative sepsis. Although pathogenic organisms were isolated preoperatively in 35% of patients, the wound infection rate after chlorhexidine baths (26%) was greater, though not significantly, than after baths with non-medicated soap (11%). An alternative theory that infection arises via lymphatics in the limb was not confirmed when organisms could not be isolated from groin lymph nodes in a group of 35 patients. The case for preoperative antiseptic regimes in vascular surgery remains unproven.