Hi
Has anyone converted back from chloraprep to standard bottles of chlorhexidine prep ( or justified not moving to single use) in their operating theatres? We have mixed practice and I'd like to get us back to using bottles of prep and swabs on swab holders to prep but need to justify what the impact might be beyond reducing single use plastic and financial savings as without this I feel that we may struggle to get any agreement. If youve done it what resources did you use to convince your Trust?
Thanks in advance
Emma
Chloraprep appears to be the only game in town, but such a retrograde step seems odd. There were reports of patients' perineums being burnt through use of bottled prep. There was at least one case of an intrathecal mis-injection of prep during administration of Spinal Anaesthesia. We should be using our energies to find a competitor to Chloraprep, I feel.
The hard plastic body could be replaced with an eco-plastic or a cellulose resin, for instance. What other companies used to supply prep, that have seen their market share dwindle?
Shall we write to them??
P.S. Your avatar is upside down. Are you trying to tell us something?
Hi thanks for responding
I think we can discount the intrathecal injection. Im not talking about converting to non spray for neuraxial block but rather referring to surgical skin prep
Where burning has occurred this is often related to excess volumes being used and not being dried adequately before surgical incision which may be diathermy based
I agree that sticks could be made from better materials if we have to stick with it but it feels like the move to single use was based on cotamination risk which I just cant buy into and wondered what others have achived in converting
Just picking up on this rather late. This conversation was started in our trust too as the educational poster in collab with chloraprep hinted at waste increase was upsetting the surgical teams. In the end after meeting with the manufacture company's sustainability team member, they seemed to have little or no carbon data and the I felt the whole exercise to be nearing greenwashing and a non-evidence based- virgin plastic = no contamination model. I find this hard when single use diagnostic EP cardiology catheters can be "re-manufactured", re-sterilised, re-packaged and then re-used in a different patient for an invasive procedure by certain companies.
re converting back to chlorhexidine - as an anaesthetist - when in theatre I use 0.5% chlorhexidine spray instead of chloraprep as much as I can (skin prep prior to IV cannulation/spinal and regional anaesthesia etc) as object both to the cost and plastic waste of chloraprep. Evidence suggests 0.5% is just as effective as 2% (chloraprep is 2%). Not sure why chloraprep has taken over in recent years but do think we should as a body question this.
Association of Anaesthetists safety guidelines suggest that we should all be using 0.5% chlorhexidine for skin asepsis before CNB. There is lack of convincing eveidence of the superiority of a 2% solution of chlorhexidine in alcohol over a 0.5% solution, but the presence of clear evidence of the neurotoxicity of chlorhexidine. So chloraprep should not be used in this situation anyway. That's before we even start talking about the plastic waste associated with chloraprep.
Please log in or sign up to comment.