Summary of findings for the main comparison. Preoperative showering with chlorhexidine 4% compared to placebo.
| pre‐operative showering with Chlorhexidine 4% compared to placebo for surgical patients | ||||||
|
Patient or population: surgical patients Settings: Hospitals Intervention: pre‐operative showering with Chlorhexidine 4% Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| placebo | pre‐operative showering with Chlorhexidine 4% | |||||
| Surgical site infection Follow‐up: 1 ‐ 6 weeks1 | Low risk population | RR 0.91 (0.8 to 1.04) | 7791 (4 studies) | ⊕⊕⊕⊕ high2 | ||
| 30 per 1000 | 27 per 1000 (24 to 31) | |||||
| High risk population | ||||||
| 100 per 1000 | 91 per 1000 (80 to 104) | |||||
| Allergic reaction Follow‐up: 1 ‐ 6 weeks1 | Study population | RR 0.89 (0.36 to 2.19) | 3589 (2 studies) | ⊕⊕⊕⊝ moderate3 | ||
| 6 per 1000 | 5 per 1000 (2 to 13) | |||||
| Medium risk population | ||||||
| 3 per 1000 | 3 per 1000 (1 to 7) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Some studies followed patients only until hospital discharge; however, as these studies are over 20 years old, we have assumed 7 days. 2 In one trial, five months into the study, the placebo solution was found to contain a microbiological agent. The solution was changed for the remaining 17 months of the trial. There was a total of over 7,000 participants included in this outcome, so we do not believe that the overall effect estimate would have been substantially altered. 3 Only 19 events were reported. All of these were from one trial.