Advantages of ChloraPrep preoperative skin preparation include its broad spectrum, rapid-acting and persistent antimicrobial activity (48 hours) and effectiveness in the presence of blood and organic matter. These advantages are a result of the unique 2% CHG/70% IPA formulation of ChloraPrep preoperative skin preparation. Chlorhexidine gluconate, a cationic bisbiguanide, works by destroying the bacterial cell membrane and precipitating cell contents. Alcohol denatures cell proteins. As a result, ChloraPrep preoperative skin preparation provides better broad spectrum, immediate, cumulative and residual antibacterial activity compared to traditional iodophors.

In contrast, traditional iodophors can take two to three minutes until the free release of iodine can occur. While the iodophor dries, free iodine becomes available. The iodine then attacks the bacterial cell and the oxidation of two sulfhydryl groups, resulting in the formation of a disulfide bond. The effectiveness of iodophors is ≤ three hours. Lastly, iodophors are neutralized in the presence of blood and organic matter and have greater irritation than the CHG solution.⁴

The chlorhexidine bisbiguanide groupings associate strongly to exposed anionic sites on the cell wall and cell membrane, particularly acidic phospholipids and proteins, causing displacement of divalent cations (Ca2+ and Mg2+). Bridging adjacent phospholipids in the cell membrane will cause a loss of structural integrity, reduce membrane fluidity and allow leakage of cellular materials.⁷

Bacterial cells are negatively charged, but in the presence of chlorhexidine, the bacterial cell is neutralized and the charge is reversed. The attraction of the cationic chlorhexidine molecule and the negatively charged bacterial cell contributes to a rapid rate of bacterial kill; surface charge reversal is secondary to cell death.⁴

Yes. After submitting a new drug application (NDA) to the Food and Drug Administration (FDA), ChloraPrep preoperative skin preparation received FDA approval in 2000.

When seeking Food and Drug Administration (FDA) approval for an over-the-counter antiseptic, all manufacturers of chlorhexidine-based solutions are required to submit a new drug application (NDA). The review of a NDA by the FDA includes evaluation of clinical, manufacturing and labeling information to assure the product is safe and effective.

Alcohol and iodophors were identified by the FDA as "generally recognized as safe and effective" (GRASE) and are included in the tentative final monograph from the FDA. As a result, manufacturers of alcohol, iodophors and iodine-based solutions can market products without submitting efficacy and safety data and product labeling to the FDA for review prior to marketing and selling their products.

ChloraPrep™ preoperative skin preparation meets the Centers for Disease Control and Prevention (CDC) Guidelines for the Prevention of Intravascular Catheter-Related Infections, published in 2002. The guidelines state to "clean skin with a > 0.5% chlorhexidine preparation with alcohol before central venous catheter and peripheral arterial catheter."

The use of a 2% chlorhexidine-based preparation for cutaneous antisepsis is classified as a Category 1A recommendation—the highest level of recommendation the Centers for Disease Control and Prevention (CDC) bestows. A Category 1A recommendation is clean skin with a > 0.5% chlorhexidine preparation with alcohol before central venous catheter and peripheral arterial catheter.

Yes. A prospective blood culture study showed CHG was highly effective in reducing the contamination rate of blood cultures. The rate of blood culture contamination was lowered to 0.5% (1 of 215 cultures) with CHG.⁵ Another blood culture study found that tincture of iodine yielded a slightly higher contamination rate than chlorhexidine. In addition, iodine tincture has the disadvantage of being toxic when used repeatedly, while toxicity was found to be very uncommon with chlorhexidine.⁶

Yes. Chlorhexidine gluconate is highly recommended by at least 18 organizations and initiatives, with 11 specifically advocating a 2% formulation.

Yes. Chlorhexidine-based antiseptics have been used globally for more than 50 years and have been widely used in Europe, Canada and Japan for more than 30 years. In the United States alone, more than 100 studies (excluding those focused on hygiene data) have been published, revealing positive outcomes related to the use of chlorhexidine gluconate (CHG)-based antiseptics. Studies that used ChloraPrep preoperative skin preparation specifically represent close to 25% of the published CHG data in the healthcare setting.

Prepping time varies by the location and size of the prep site and applicator used. Gently apply with a back and forth motion, concentrating at the insertion/incision site/s for 30 seconds before working outwards to the periphery. Always let the solution air dry fully before continuing with the procedure.

The combination of fast-acting and long-lasting antimicrobial activity is the key to an effective preoperative skin preparation. IPA alone provides a 99.99% reduction in bacteria, but it does not provide long-lasting microbial kill. CHG maintains antimicrobial activity, demonstrating 2 log10 and 3 log10 for at least 48 hours1,2 compared to two hours for free iodine.3Because ChloraPrep preoperative skin preparation contains the combination of isopropyl alcohol and chlorhexidine, it is more effective than isopropyl alcohol alone.

Use with care in premature infants or infants under 2 months of age. These products may cause irritation or chemical burns.

Yes. ChloraPrep^TM  preoperative skin preparation has been tested in a surgical setting measuring bacterial colonization-reduction comparisons among preoperative skin preparations. Clinical outcomes concluded that ChloraPrep^TM  preoperative skin preparation was the most effective solution for eliminating potential wound contaminants from the forefoot prior to surgery.⁹

At the Invasive Heart Lab of Aultman Hospital in Canton, Ohio, ChloraPrep^TM  preoperative skin preparation was part of three evidence-based improvements put in place to reduce the risk of infections related to pacemakers and implantable cardioverter-defibrillators (ICDs). These evidence-based improvements and focus on heart lab protocols yielded dramatic results. For 22 months, the intensive heart lab had no infections—a 0% infection rate. "By adhering to key evidence-based standards and protocols, we are protecting our patients from avoidable infections." –Beth A. Taylor RN, BC, CVNII¹⁰

Prepping time varies by the location and size of the prep site and applicator. Prepping with ChloraPrep preoperative skin preparation is a procedure that, compared to the "scrub and paint technique," greatly reduces the amount of time required for patient preoperative skin preparation.

Each ChloraPrep applicator is appropriate for a variety of procedures, depending on the size of the area that needs to be prepped. To review a list of common applicator procedures, go to the Skin prep page.

The tint process for ChloraPrep Scrub Teal™ and Hi-Lite Orange™ tints is a patented technology that adds color to the solution as it enters the sponge pad. When applied to the skin, each tint allows for easy visualization of the prepped area. Unlike iodine-based preps, which are brown, Scrub Teal and Hi-Lite Orange tints are easy to see when applied to a variety of skin tones. The dyes in Scrub Teal and Hi-Lite Orange tints are Food, Drug and Cosmetic (FD&C) Green #3 and Yellow #6 dyes, and have been "generally recognized as safe" (GRAS) by the Food and Drug Administration (FDA). For an ingredient to be listed as GRAS, extensive safety testing is conducted, reviewed and accepted. FD&C Green #3 is a common colorant used in many applications throughout the healthcare field (e.g., eye angiography and screening for ocular dryness, routine lab testing, dye injections, histological/cytological stains for cancer screening of tissues). FD&C Green #3 and Yellow #6 were found to be stable when combined with the 2% chlorhexidine gluconate/70% isopropyl alcohol ChloraPrep formulation, which offers proven, stable and uncompromised chlorhexidine-based solutions.

It is recommended that ChloraPrep with tint remain on the skin – especially at the incision site – post-procedure, to provide maximum antimicrobial activity. The tint will slowly fade from the skin. If your facility's policies or procedures require cleanup and/or removal of the ChloraPrep tints, they can be removed with a ChloraPrep clear applicator, alcohol or soap and water.

Each ChloraPrep^TM  applicator offers a number of unique benefits to preoperative skin preparation. 

It is recommended that ChloraPrep^TM  preoperative skin preparation with tint remain on the skin, especially at the incision site, post-procedure to provide maximum antimicrobial activity. The tints will slowly fade from the skin. If your facility's policies or procedures require clean-up and/or removal of the ChloraPrep^TM  tints, they can be removed with a ChloraPrep^TM  clear applicator, alcohol, or soap and water.

The coverage area is specific to each applicator. 

• 26 mL BD ChloraPrep applicator: ~13.2 inches x ~13.2 inches
• 10.5 mL BD ChloraPrep applicator: ~8.4 inches x ~8.4 inches
• 3 mL BD ChloraPrep applicator: ~4 inches x ~5 inches
• 1mL and FREPP 1.5 mL BD ChloraPrep applicators and ChloraPrep swabstick: ~2.5 inches x ~2.5 inches

The ChloraPrep™ single and triple swabstick applicators have a two-year shelf life from the date of production. All other ChloraPrep™ products are labeled with a three-year shelf life from the date of production.

Yes. To request samples, contact ChloraPrep^TM  Customer Support at 800.523.0502 ext. 3576.