Factors to be considered when selecting an optimal sterile prep solution prior to cutaneous surgery include the underlying health status of the patient, the expected extent of the surgery, the anatomic location of the tumor to be removed or planned reconstruction, and the inherent effectiveness of the prep solution. Recently, it has been suggested that different prep solutions may pose varying risks to patients. For instance, 83% of surgical dermatologists use chlorhexidine on the face.1 On the one hand, it has been suggested that chlorhexidine use may contribute to the very low incidence of infection seen in cold-steel skin surgery and in minimally invasive cosmetic procedures such as filler injections. On the other hand, the ocular risks of chlorhexidine may outweigh the benefits. The purpose of this analysis was to compare the safety and effectiveness of prep solutions for skin surgery of the head and neck.
Murad Alam, Joel L. Cohen, Brian Petersen, Daniel I. Schlessinger, Alexandra Weil, Sanjana Iyengar, Emily Poon. Association of Different Surgical Sterile Prep Solutions With Infection Risk After Cutaneous Surgery of the Head and Neck. JAMA Dermatol. 2017;153(8):830–831. doi:10.1001/jamadermatol.2017.0995