During skin preparation for a minor office surgery, the provider asks you to select an antiseptic that acts quickly and continues to suppress microbial growth throughout the procedure. Which solution should you choose?
70 % isopropyl alcohol
2 % chlorhexidine gluconate in 70 % isopropyl alcohol
Chlorhexidine gluconate (CHG) at about 2 % in 70 % isopropyl alcohol combines the rapid, broad-spectrum kill of alcohol with the residual binding of CHG to the stratum corneum, providing antimicrobial activity that persists for hours. Plain 70 % isopropyl alcohol works quickly but loses activity as soon as it evaporates. Povidone-iodine offers broad coverage but has little residual effect once dry, and hydrogen peroxide is not recommended for surgical skin prep because of limited spectrum, tissue toxicity, and lack of sustained action.
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