Table 2 Antiseptic agents applied to open surgical incisions and used to prevent or manage post-operative surgical site infection

Acetic acid solution

Diluted solution (0.25%) has been used in incisions with no evidence to support use. Higher concentrations may cause tissue injury. The solution has been used for otitis external management and bladder irrigation

Alcohols

Isopropyl alcohol with rapid bactericidal efficacy is most commonly used for topical skin application. Not recommended for application in open incisions, because it desiccates open incisions and is tissue toxic

Boric acid

It is used as eye irrigation, and not recommended for application in open incisions

Chlorhexidine

It is the most common antiseptic in skin preparation, and generally not recommended in open incisions at the conventional concentration (2–4%)

Chlorine compounds

Buffered sodium hypochlorite solution at a concentration of 0.25–0.5%, leading to oxidative injury of bacterial membranes and enzymes

Hydrogen peroxide

It is a common household remedy for cuts and bruises, and is generally tissue-toxic for use in open incisions

Iodine compounds

Tincture of iodine has almost disappeared for any application in operations. Iodophors, which are less toxic, have been used clinically for topical application in open incisions but have not been subject to evaluation for efficacy

Silver compounds

Silver nitrate and silver sulfadiazine have been widely used in burns and selectively in open infected incisions of soft tissue. Various sustained-release topical preparations are available but are not used commonly for prevention in open incisions

Triclocarban

A common antiseptic in commercial soaps; there is no data to evaluate its use in open incisions

Triclosan

Common antiseptic in cosmetics; used in the coating for selected surgical sutures. No data on use for open incisions