{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:36:03Z","timestamp":1790379363970,"version":"4.1.0"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2015,12,28]],"date-time":"2015-12-28T00:00:00Z","timestamp":1451260800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec id=\"S0899823X15003037_abs1\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>Surgical site infections (SSIs) are responsible for significant morbidity and mortality. Preadmission skin antisepsis, while controversial, has gained acceptance as a strategy for reducing the risk of SSI. In this study, we analyze the benefit of an electronic alert system for enhancing compliance to preadmission application of 2% chlorhexidine gluconate (CHG).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15003037_abs2\" sec-type=\"general\"><jats:title>DESIGN, SETTING, AND PARTICIPANTS<\/jats:title><jats:p>Following informed consent, 100 healthy volunteers in an academic, tertiary care medical center were randomized to 5 chlorhexidine gluconate (CHG) skin application groups: 1, 2, 3, 4, or 5 consecutive applications. Participants were further randomized into 2 subgroups: with or without electronic alert. Skin surface concentrations of CHG (\u03bcg\/mL) were analyzed using a colorimetric assay at 5 separate anatomic sites.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15003037_abs3\" sec-type=\"general\"><jats:title>INTERVENTION<\/jats:title><jats:p>Preadmission application of chlorhexidine gluconate, 2%<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15003037_abs4\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>Mean composite skin surface CHG concentrations in volunteer participants receiving EA following 1, 2, 3, 4, and 5 applications were 1,040.5, 1,334.4, 1,278.2, 1,643.9, and 1,803.1 \u00b5g\/mL, respectively, while composite skin surface concentrations in the no-EA group were 913.8, 1,240.0, 1,249.8, 1,194.4, and 1,364.2 \u00b5g\/mL, respectively (ANOVA, <jats:italic>P<\/jats:italic>&lt;.001). Composite ratios (CHG concentration\/minimum inhibitory concentration required to inhibit the growth of 90% of organisms [MIC<jats:sup>90<\/jats:sup>]) for 1, 2, 3, 4, or 5 applications using the 2% CHG cloth were 208.1, 266.8, 255.6, 328.8, and 360.6, respectively, representing CHG skin concentrations effective against staphylococcal surgical pathogens. The use of an electronic alert system resulted in significant increase in skin concentrations of CHG in the 4- and 5-application groups (<jats:italic>P<\/jats:italic>&lt;.04 and <jats:italic>P<\/jats:italic>&lt;.007, respectively).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15003037_abs5\" sec-type=\"conclusion\"><jats:title>CONCLUSION<\/jats:title><jats:p>The findings of this study suggest an evidence-based standardized process that includes use of an Internet-based electronic alert system to improve patient compliance while maximizing skin surface concentrations effective against MRSA and other staphylococcal surgical pathogens.<\/jats:p><jats:p><jats:italic>Infect. Control Hosp. Epidemiol.<\/jats:italic> 2016;37(3):254\u2013259<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2015.303","type":"journal-article","created":{"date-parts":[[2015,12,28]],"date-time":"2015-12-28T08:58:21Z","timestamp":1451293101000},"page":"254-259","source":"Crossref","is-referenced-by-count":21,"title":["Preadmission Application of 2% Chlorhexidine Gluconate (CHG): Enhancing Patient Compliance While Maximizing Skin Surface Concentrations"],"prefix":"10.1017","volume":"37","author":[{"suffix":"Jr","given":"Charles E.","family":"Edmiston","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace J.","family":"Krepel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen P.","family":"Spencer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro A.","family":"Ferraz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary R.","family":"Seabrook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheong J.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie R.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Malinowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Edmiston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmundo M.","family":"Ferraz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Leaper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,12,28]]},"reference":[{"key":"S0899823X15003037_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.07.050"},{"key":"S0899823X15003037_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2012.10.004"},{"key":"S0899823X15003037_ref2","doi-asserted-by":"publisher","DOI":"10.1177\/003335490712200205"},{"key":"S0899823X15003037_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2012.10.030"},{"key":"S0899823X15003037_ref6","doi-asserted-by":"publisher","DOI":"10.1086\/509827"},{"key":"S0899823X15003037_ref3","first-page":"27","article-title":"Infection control and prevention: a review of hospital-acquired infections and the economic implications","volume":"9","author":"Reed","year":"2009","journal-title":"Oscher J"},{"key":"S0899823X15003037_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.12.054"},{"key":"S0899823X15003037_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.01.061"},{"key":"S0899823X15003037_ref23","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12243"},{"key":"S0899823X15003037_ref8","unstructured":"Ambulatory Surgery in the United States, 2006. Centers for Disease Control and Prevention website. http:\/\/www.cdc.gov\/nchs\/data\/nhsr\/nhsr011.pdf. Published 2009. Accessed August 1, 2015."},{"key":"S0899823X15003037_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-6553(99)70088-X"},{"key":"S0899823X15003037_ref22","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2011.036"},{"key":"S0899823X15003037_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.aorn.2015.02.008"},{"key":"S0899823X15003037_ref16","first-page":"CD004985","article-title":"Preoperative bathing or showering with skin antiseptics to prevent surgical site infection","volume":"2","author":"Webster","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"S0899823X15003037_ref14","unstructured":"The USP Official Monograph for the identification of chlorhexidine gluconate solution. The United States Pharmacopeia (USP 29). The National Formulary (NF 24). Rockville, MD: The United States Pharmacopeia Convention; 2006: 477\u2013478."},{"key":"S0899823X15003037_ref12","first-page":"127","article-title":"The effect of reminder systems on patient\u2019s adherence to treatment","volume":"6","author":"Fenerty","year":"2012","journal-title":"Patient Preference Adherence"},{"key":"S0899823X15003037_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.12.010"},{"key":"S0899823X15003037_ref19","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2015.2210"},{"key":"S0899823X15003037_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-6787.2010.00201.x"},{"key":"S0899823X15003037_ref21","doi-asserted-by":"publisher","DOI":"10.1086\/676022"},{"key":"S0899823X15003037_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.2246"},{"key":"S0899823X15003037_ref1","unstructured":"National Hospital Discharge Survey: 2010 table, Procedures by selected patient characteristics\u2014number by procedure category and age. Centers for Disease Control and Prevention website. http:\/\/www.cdc.gov\/nchs\/fastats\/inpatient -surg.htm. Published 2010. Updated August 9, 2015. Accessed August 11, 2015."},{"key":"S0899823X15003037_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.aorn.2010.01.020"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X15003037","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T21:59:57Z","timestamp":1555711197000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X15003037\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,28]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["S0899823X15003037"],"URL":"https:\/\/doi.org\/10.1017\/ice.2015.303","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,28]]}}}