Effectiveness of Preoperative Skin Antisepsis in Reducing Infections: An Observational Study

Abstract

Surgical site infections (SSIs) remain a significant cause of postoperative morbidity, prolonged hospital stay, and increased healthcare costs, particularly in resource-limited settings. Effective preoperative skin antisepsis is a critical preventive strategy to reduce microbial load at the surgical site and minimize infection risk. To assess the effectiveness of preoperative skin antisepsis in reducing postoperative surgical site infections among patients undergoing surgery, this prospective cohort study was conducted from January 2025 to February 2026 at the 250 Bedded Hospital, Sadar, Magura, and Upazilla Health Complex, Sreepur, Magura, Bangladesh. A total of 287 patients undergoing elective and emergency surgical procedures were selected using purposive sampling. Data were collected using a structured questionnaire and clinical observation checklist. Patients were followed for 30 days postoperatively to identify the occurrence of SSIs. Data were analyzed using SPSS version 23.0. Among the 287 participants, the overall SSI rate was 11.5%. Patients who received standardized preoperative skin antisepsis with chlorhexidine-alcohol had a significantly lower SSI rate (7.2%) compared to those receiving povidone-iodine alone (16.8%) (χ² = 6.87, p = 0.009). The relative risk of SSI was 0.43 (95% CI: 0.22–0.84) in the chlorhexidine-alcohol group. Prolonged operative time and diabetes were identified as additional significant risk factors (p < 0.05). Standardized preoperative skin antisepsis, particularly with chlorhexidine-alcohol, significantly reduces the incidence of surgical site infections. Strengthening antiseptic protocols may improve surgical outcomes in similar healthcare settings. 

CBMJ 2026 July: Vol. 15 No. 02 P:349-355