Research ArticleResearchInfection ControlWorkflow

Two pre-op chlorhexidine rinses reduced surgical-site infections in one abdominal-surgery trial

BMJ Global Health (PubMed)Jul 29, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

In a double-blind randomized trial of 228 adults with poor oral hygiene undergoing short elective abdominal surgery, two preoperative 0.2% chlorhexidine mouth rinses reduced surgical-site infection compared with saline (4.39% versus 21.93%).

What NurseJet pulled from the source

Participants were adults with ASA physical status I or II undergoing elective abdominal surgery under general anesthesia for less than four hours. Chlorhexidine also reduced postoperative sore throat and positive bacterial cultures and was associated with shorter hospitalization. Pneumonia rates were low and comparable between groups.

Why this matters for nurses

Preoperative oral care is a nurse-visible infection-prevention step that can be standardized, documented, and audited. The large single-trial effect is clinically notable, but it should be evaluated against the local surgical bundle and patient-specific contraindications before adoption.

Bedside takeaway

Two preoperative chlorhexidine mouth rinses reduced surgical-site infections in adults with poor oral hygiene in one trial.

How This Applies in Practice

Use this when: Preparing an eligible adult for short elective abdominal surgery when chlorhexidine oral care is part of the approved pathway.

On your shift

Verify the ordered oral preparation, concentration, timing, documented sensitivities, and the patient's ability to rinse safely.
Provide the approved instructions, supervise administration when indicated, and document each completed rinse.
Continue every other element of the surgical-site infection prevention bundle and escalate omissions or adverse reactions.

Keep in mind: The intervention was tested in one defined population and does not replace other infection-prevention measures. Follow the perioperative protocol, facility policy, and provider orders.

Key takeaways

The trial randomized 228 adults with poor oral hygiene to two preoperative rinses with 0.2% chlorhexidine or normal saline.
Surgical-site infection occurred in 4.39% of the chlorhexidine group and 21.93% of the saline group.
Postoperative sore throat and positive bacterial cultures were also less frequent with chlorhexidine.
Pneumonia rates were low and did not differ between groups.

Practice implications

If chlorhexidine oral preparation is ordered or included in the approved preoperative pathway, verify the product and timing, screen for documented sensitivity, supervise use when needed, and record completion. Continue the full surgical-site infection bundle rather than treating oral preparation as a substitute.

Limitations & cautions

This single trial enrolled relatively low-risk adults with poor oral hygiene at a North Indian center and included surgeries lasting less than four hours. Event counts were limited, pneumonia was uncommon, and the findings may not transfer to other procedures, populations, oral-care products, or infection-prevention bundles.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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BMJ Global Health (PubMed)

BMJ Global Health (PubMed). Preoperative chlorhexidine mouthwash to prevent postoperative infections in low-risk elective abdominal surgeries: a double-blind RCT from North India among patients with poor oral hygiene.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42526937/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

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Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

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AI-summarized from the linked source. Review the original article before applying to practice.

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Nursing implications

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How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

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