Effect of Using Chlorhexidine Gluconate as a Preoperative Skin Antiseptic on Reduction of Neonatal Surgical Wound Infection

Purpose Neonates are particularly vulnerable to infection-related complications, with surgical site infections (SSI) being a significant concern in this population. This study aimed to evaluate the efficacy of preoperative bathing with 2% chlorhexidine gluconate (CHG) in reducing the incidence of postoperative wound infections in full-term neonates undergoing clean and clean- contaminated surgeries, compared to standard skin preparation with soap. Methods This randomized controlled clinical study was conducted at the surgical Neonatal Intensive Care Unit (NICU) of Children’s Hospital, Ain Shams University, from January to August 2023. Fifty full-term neonates were randomized into two groups: the control group received standard NICU care with twice-daily bathing using non-irritant soap, while the chlorhexidine group received twice-daily bathing with 2% CHG until the time of surgery. Primary outcomes included the incidence of SSI, while secondary outcomes assessed CHG side effects, changes in laboratory data, need for mechanical ventilation, and mortality. Results The incidence of SSI was significantly lower in the chlorhexidine group (29.2%) compared to the control group (70.8%) (P = 0.005). Deep SSIs were more common in the control group (16.7% vs. 4.1%, P = 0.001). The chlorhexidine group also showed less infection rates outcomes, with a higher incidence of negative blood cultures (60% vs. 16%, P = 0.001) and lower mortality (8% vs. 32%, P = 0.034). The median duration of hospital stay was shorter in the chlorhexidine group (9 days vs. 10 days, P = 0.041). Mild, transient local erythema was observed in 16% of the chlorhexidine group, though this was not statistically significant (P = 0.294). Conclusion Preoperative bathing with 2% CHG significantly reduced the incidence of SSIs and improved postoperative outcomes in neonates compared to standard soap. While the study’s small sample size and single-center design may limit generalizability, the results align with existing literature supporting CHG’s efficacy and safety in neonatal surgical settings. Future research should confirm these findings in larger, multicenter trials and explore the long-term outcomes of CHG use.