Annex 1. Table (1) Options for antiseptic skin preparation (NICE guideline, Surgical site infections: prevention and treatment, updated 2020)
|
When |
Choice of antiseptic skin preparation |
|
First choice unless contraindicated or the surgical site is next to a mucous membrane |
Alcohol-based solution of chlorhexidine 0.5% chlorhexidine in 70% alcohol solution for ‘preoperative skin disinfection prior to minor surgical procedures’ and 2.0% chlorhexidine in 70% alcohol applicators for ‘disinfection of the skin prior to invasive medical procedures. |
|
Alternative if the surgical site is next to a mucous membrane |
Aqueous solution of chlorhexidine 4.0% aqueous chlorhexidine for ‘preoperative and postoperative skin antisepsis for patients undergoing elective surgery’; however, relevant instructions were limited to use as a body wash to be used before the person enters the operating theatre. |
|
Alternative if chlorhexidine is contraindicated |
Alcohol-based solution of povidone-iodine 10% povidone-iodine alcoholic solution for ‘topical application’. 10% povidone-iodine (Betadine Alcoholic solution) was licensed for ‘antiseptic skin cleanser for major and minor surgical procedures. |
|
If both an alcohol- based solution and chlorhexidine are unsuitable |
Aqueous solution of povidone-iodine 7.5% povidone-iodine surgical scrub solution for disinfecting the site of incision prior to elective surgery’ and 7.5% povidone-iodine (Betadine surgical scrub) for ‘preoperative preparation of patients’ skin’. 10% iodine antiseptic solution for ‘disinfection of intact external skin or as a mucosal antiseptic’ and 10% povidone-iodine solution (Standardised Betadine antiseptic solution) for ‘preoperative and postoperative antiseptic skin cleanser for major and minor surgical procedures. |
Annex2. Surgical Hand rubbing Technique, World Health Organization

Annex 3. The 5 Moments for Hand Hygiene for a patient with post- operative wound, World Health Organization
