CHG4

CHG4 Antiseptic Skin Cleanser

Surgical hand scrub

• • • wet hands and forearms under running water.
    • scrub for 3 minutes with about 5 ml of product and a wet brush, paying close attention to the nails, cuticles, and interdigital spaces.
    • a separate nail cleaner may be used
    • rinse thoroughly
    • wash for an additional 3 minutes with 5 ml of product and rinse under running water
    • dry thoroughly

Healthcare personnel handwash

• • • wet hands with water.
    • dispense about 5 ml of product into cupped hands and wash in a vigorous manner for 15 seconds
    • rinse and dry thoroughly

Patient preoperative skin preparation

• • • apply product liberally to surgical site and swab for at least 2 minutes and dry with a sterile towel
    • repeat procedure for an additional 2 minutes and dry with a sterile towel

Skin wound and general skin cleansing

• • • thoroughly rinse the area to be cleaned with water
    • apply the minimum amount of product necessary to cover the skin or wound area and wash gently
    • rinse again thoroughly

• • • Neck, shoulders, and chest.
    • Both arms and hands.
    • Abdomen then groin and perineum.
    • Right leg and foot.
    • Left leg and foot.
    • Back of neck, back and then buttocks.
    • Skin may feel sticky for a few minutes. Do NOT wipe off. Allow to air dry.

CHG4 Antiseptic Skin Cleanser

• When to use CHG4
  With multiple indications, CHG4 has a great deal of utility throughout the hospital facility.

The 4% chlorhexidine gluconate solution is in a gentle, skin cleansing base that can be used for:

• • • Daily patient bed baths, as part of a horizontal infection prevention approach.
    • Preoperative / postoperative showering and decolonization, as part of surgical site infection prevention bundles.
    • Surgical hand scrubbing.
    • Personnel hand washing.
    • Preoperative skin preparation.

CHG4 Antiseptic Skin Cleanser

Chlorhexidine is a broad-spectrum biocide effective against Gram-positive bacteria, Gram-negative bacteria and fungi. Chlorhexidine inactivates microorganisms with a broader spectrum than other antimicrobials (e.g. antibiotics) and has a quicker kill rate than other antimicrobials (e.g. povidone-iodine).It has both bacteriostatic (inhibits bacterial growth) and bactericidal (kills bacteria) mechanisms of action, depending on its concentration. Chlorhexidine kills by disrupting the cell membrane. Upon application in vitro, chlorhexidine can kill nearly 100% of Gram-positive and Gram-negative bacteria within 30 seconds.10 Since chlorhexidine formulations can destroy the majority of categories of microbes, there is limited risk for the development of an opportunistic infections.

• • Bacteria

Chlorhexidine is a positively-charged molecule that binds to the negatively-charged sites on the cell wall; it destabilizes the cell wall and interferes with osmosis. The bacterial uptake of the chlorhexidine is very rapid, typically working within 20 seconds. In low concentrations it affects the integrity of the cell wall. Once the cell wall is damaged, chlorhexidine then crosses into the cell itself and attacks the cytoplasmic membrane (inner membrane). Damage to the cytoplasm’s delicate semipermeable membrane allows for leakage of components leading to cell death.¹ In high concentrations, chlorhexidine causes the cytoplasm to congeal or solidify.

• Fungi

  The mechanism of action for fungi is very similar to bacteria. The fungus uptakes chlorhexidine in a short amount of time1 and impairs the integrity of the cell wall and the plasma membrane entering the cytoplasm resulting in leakage of cell contents and cell death.

• Biofilm

Biofilms are a complex aggregation of microorganisms growing on a solid substrate. They can occur on organic (e.g. dental plaque) or inorganic surfaces. Biofilms are characterized by structural heterogeneity, genetic diversity, complex community interactions, and an extracellular matrix of polymeric substances. This matrix protects the cells within it and increases their resistance to antimicrobials. Many antimicrobial agents have a difficult time eliminating organisms in a biofilm. Chlorhexidine has shown some ability to help inhibit adherence of microorganisms to a surface thereby preventing growth and development of biofilms.

• Other Microbial Organisms

  Unlike other antimicrobials, chlorhexidine has demonstrated some effectiveness against microorganisms in other forms and states as well. This includes bacterial spores and protozoa.

Bactericidal, Fungicidal, Virucidal