Visibility of Tinted Chlorhexidine-Alcohol Based Preoperative Skin Preparations on Dark Skin Tones.

Author(s):
Joan Paulson; Dan Morse; Kimberly Prinsen; Angela Hollingsworth; Muhammed Hamid Bashir; Assumpta Bennaars-Eiden

Background:

Preoperative skin preps are designed to reduce microorganisms on the skin that may lead to surgical site infections. Color tint may be added to the skin preparation for improved visibility on a variety of skin tones. The study objective was to evaluate visibility of two tinted CHG-based preoperative skin preps on dark skin. A green-tinted investigational prep was tested against an orange-tinted marketed prep.

Hypothesis:

The color of perioperative skin preparation solution may affect the visibility on darker skin tones.

Methods:

Pantone Skin Tone™ Guide was used for recruitment. The guide divides pigmentation into 15 tones: lightest (01) to darkest (15). Subjects in the 11 to 15 range were eligible for enrollment. OR nurses evaluated visibility.

Each prep was applied to half the back of each subject. Each prepped site was assessed randomly and independently. Visibility was rated using a grading scale:

1	2	3	4	5	6	7
Extremely difficult	Difficult	Somewhat difficult	Neither easy nor difficult	Somewhat easy	Easy	Extremely easy

Results:

Average visibility rating was 5.98 for the green-tinted prep and 3.27 for the orange-tinted prep. For green, two nurses had average ratings <4 and 25 nurses had average ratings >4. For orange, 19 nurses had average ratings <4, two nurses had average ratings of 4 and six nurses had average ratings >4. In paired average rating for both preps, one nurse judged no difference between products in ability to visualize preps and 26 nurses judged easier to visualize green over orange.

Conclusions:

Comparison of 2% chlorhexidine gluconate/70 % isopropyl alcohol perioperative skin preparations showed that green tinted skin prep was easier to see than orange tinted skin prep solution on dark skin tones for 26 of 27 nurses (96%, P<.0001).