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BD ChloraPrep™ Patient Preoperative Skin Preparation

Leading the way in effective pre-op skin preparation

BD ChloraPrep™ patient preoperative skin preparation delivers standardized, powerful, persistent antimicrobial protection that is backed by more than 60 clinical studies and trusted by healthcare providers for more than 21 years. In a recent clinical study, BD ChloraPrep™ preoperative skin antiseptic demonstrated antimicrobial persistence for at least 7 days.¹

BD ChloraPrep™ with Sterile Solution has a full portfolio of products to meet the coverage area needs of each patient: 1mL, Frepp™ 1.5 mL, 3mL, 10.5 mL, and 26 mL sizes.

Beausoleil C, Comstock SL, Werner D, Li L, Eby JM, Zook EC. Antimicrobial persistence of two alcoholic preoperative skin preparation solutions. J Hosp Infect. 2022 Nov;129:8-16.

BD ChloraPrep™ patient preoperative skin preparation with sterile solution delivers standardized, powerful, persistent antimicrobial protection that is backed by more than 60 clinical studies and trusted by healthcare providers for more than 21 years. In a recent clinical study, BD ChloraPrep™ preoperative skin antiseptic demonstrated antimicrobial persistence for at least 7 days.¹ BD ChloraPrep™ skin prep products deliver the unmatched experience of nearly 5 billion applicators sold in 38 countries with unparalleled evidence supporting efficacy and safety.²

BD ChloraPrep™ applicators with Sterile Solution has a full portfolio of products to meet the coverage area needs of each patient: 1mL, Frepp™ 1.5 mL, 3mL, 10.5 mL, and 26 mL sizes.

Sterile Applicator and Solution

Patented sterilization technology maintains the efficacy and purity of the antiseptic solution.³

Persistent

Maintaining lower levels of bacteria on the skin while healing is important to minimize bacteria entering the incision site or skin break. In a recent clinical study, BD ChloraPrep™ skin antiseptic demonstrated antimicrobial persistence for at least 7 days.¹

Standardized Processes and Cost Savings

BD ChloraPrep™ skin preparation is the only skin prep that offers a wide range of coverage areas to fit your clinical needs and allows for cost-saving standardized skin prep across care settings. Choose from a range of product options to fit your needs – and the color of your patient’s skin tone. Use Hi-Lite™ orange for lighter pigmented skin, Scrub Teal™ for darker pigmented skin, or clear when you want a colorless effect.

Surgical Portfolio of Fully Sterile Alcohol-Based Skin Antiseptics

BD ChloraPrep™ skin prep for your surgical skin antisepsis and BD PurPrep™ skin prep, an effective alternative when chlorhexidine plus alcohol is not indicated.

1. Beausoleil C, Comstock SL, Werner D, Li L, Eby JM, Zook EC. Antimicrobial persistence of two alcoholic preoperative skin preparation solutions. J Hosp Infect. 2022 Nov;129:8-16.

2. Data on File

3. Degala, et al. United States Patent 9,078,934. July 14, 2015.

BD’s top priority is ensuring the safety, quality and regulatory compliance of the products our customers rely on every day.  

BD is currently experiencing a supply interruption affecting BD^® ChloraPrep™ 1.5 mL Frepp Applicator with Sterile Solution™ Single Sterile (SKU 930299) and BD^® ChloraPrep™ 1 mL Clear Applicator with Sterile Solution™ Single Sterile (SKU 930480).

The supply of BD^® ChloraPrep™ Hi-Lite Orange™ Tint Applicator with Sterile Solution™ (SKU 930415) is available. Swabsticks such as BD^® ChloraPrep™ 1.75 mL Single Swabstick with Sterile Solution™ (SKU 930100) are also available for orders.

BD is currently experiencing a rolling backorder affecting BD^® ChloraPrep™ 3 mL Clear Applicator with Sterile Solution™ Single Sterile (SKU 930400). The backorder is due to lower-than-anticipated production output.

The supply of BD^® ChloraPrep™ Hi-Lite Orange™ Tint Applicator with Sterile Solution™ (SKU 930415) is available. BD^® ChloraPrep™ 5.75 mL Triple Swabstick with Sterile Solution™ (SKU 930103) is also available for orders.

We recognize the important role these products play in patient care and are working to restore supply as quickly as possible. This page serves as a central resource for the latest product availability updates, alternative product information, and customer support contacts. For supply updates related to BD ChloraPrep contained within kits, the local BD representative should be contacted.

The tables below provide a product inventory view at the Product Set level. We expect to be at positive inventory levels in BD Distribution Centers by the last day of the month indicated in the Expected U.S. Channel Recovery column. On that date, the item will move to normal “In Stock” status but may remain on manual allocation to ensure we maintain fair and balanced supply to customers for items with accelerated demand.

“In Stock” status indicates that Product Sets currently have healthy inventory levels and a steady production plan that will accommodate projected demand forecast throughout 2026.
“Backordered” status indicates items where BD has paused shipment to our customers and channel partners.
“Rolling backorder” indicates items where BD will continue to experience less than full fill rate on orders. There is no disruption in our ability to manufacture these products. We continue to produce and ship products every day to our distributors to service customers.
“Manual Allocation” status indicates Product Sets that are in heightened demand. The unique situation of BD^® ChloraPrep™ Skin Preparation products requires a specific “Manual Allocation” process that enhances our ability to minimize disruption. This allocation process allows us to optimize the supply of these items across our entire customer base. Product may remain on allocation even if status is “In Stock” to protect inventory levels. Currently, as inventory arrives at the BD Distribution Center from the manufacturing plant, it is immediately allocated to open orders to be scheduled for shipment.

ChloraPrep™ Patient Preoperative Skin Preparation with Sterile Solution™

Product Set	Disinfecting Area	Status	Expected US Channel Recovery	BD Manual Allocation
BD^® ChloraPrep™ Skin Preparation Swabstick
BD^® ChloraPrep™ 1.75 mL Single Swabstick with Sterile Solution™ (BD #930100)	2.5 in x 2.5 in	In stock	N/A	Yes
BD^® ChloraPrep™ 5.25 mL Triple Swabstick with Sterile Solution™ (BD #930103)	5 in x 5 in	In stock	N/A	Yes
BD^®ChloraPrep™ Skin Preparation Applicators
BD^® ChloraPrep™ 1 mL Clear Applicator with Sterile Solution™ (BD #930480)	2.5 in × 2.5 in	Rolling Backorder	Q2 2027	Yes
BD^® ChloraPrep™ Frepp™ 1.5 mL Clear Applicator with Sterile Solution™ (BD #930299)	2.5 in × 2.5 in	Rolling Backorder	Q2 2027	Yes
BD^® ChloraPrep™ 3 mL Clear Applicator with Sterile Solution™ (BD #930400)	4 in x 5 in	Rolling Backorder	Q4 2027	Yes
BD^® ChloraPrep™ 3 mL Hi-Lite Orange Tint Applicator with Sterile Solution™ (BD #930415)	4 in x 5 in	In stock	N/A	Yes

Last Updated: September 2, 2026

BD ChloraPrep™ Preoperative Skin Preparation Product Information

For more details about the recent Field Actions, please click the links below:

BD ChloraPrep 1 mL Field Action – July 2026
BD ChloraPrep 1 mL / Frepp Field Action – May 2026

Clinical Resources

When considering alternative skin antiseptic products, Customers should review current institutional, infection prevention, and facility protocols while appplying clinical judgment when selecting a skin antiseptic based on the patient's condition and procedural considerations. Customers may consult national guidelines and standards for invasive procedures:

CDC Guidelines
- Prepare clean skin with a >0.5% chlorhexidine preparation with alcohol before central venous catheter and peripheral arterial catheter insertion and during dressing changes. If there is a contraindication to chlorhexidine, tincture of iodine, an iodophor, or 70% alcohol can be used as alternatives. (Link)
- Perform intraoperative skin preparation with an alcohol-based antiseptic agent unless contraindicated. (Link)
INS Standards
- Perform skin antisepsis using the preferred skin antiseptic agent of alcohol-based chlorhexidine solution. If there is a contraindication to chlorhexidine solution, an iodophor (e.g., povidone-iodine) or 70% alcohol may also be used.
- Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice. J Infus Nurs. 2021;44(suppl 1): S1-S224. doi:10.1097/NAN.0000000000000396
BD ChloraPrep™ Preoperative Skin Preparation Indication
- For the preparation of the patient’s skin prior to surgery. Helps to reduce bacteria that potentially can cause skin infection.

For additional clinical inquiries and guidance on alternative recommendations, contact BD Medical Information at medical.information@bd.com or 1-800-555-7422 x 4.

Clinical Inquiries and Guidance

For additional clinical inquiries and guidance on alternative recommendations, contact BD Medical Information at medical.information@bd.com or 1-800-555-7422 x 4.

Supply Inquiries

For any supply inquiries, contact your sales representative

Customer Service

If you have any questions about this situation or need customer support, please contact BD Customer Service at 1-800-523-0502 or your local BD sales representative.

BD-133677 (09/26)

Leading the way in effective pre-op skin prep solutions and setting the standard of care in surgical infection prevention

ChloraPrep™ is the first antiseptic solution with a 2% chlorhexidine gluconate (CHG) / 70% isopropyl alcohol (IPA) formulation and provides distinct advantages over other products in how to prepare for surgery.

How does your current antiseptic solution compare?

Feature	BD ChloraPrep™	Other Antiseptics	BD ChloraPrep™ value
Formulation			Proven broad spectrum, rapid acting antiseptic combination of 2% CHG and 70% IPA with the option for tint. The formulation contains no additional excipients.
Available Sizes			Vascular and Surgical sizes for consistency in prepping processes.
Sterile Applicators with Sterile Solution			Less than 1 in a million chance that a viable microorganism can exist in the solution.¹
Persistence			At least 7 days.²
Studies & Independent Data			Supported by more than 60 published peer-reviewed clinical studies.
Tint Options			Hi-Lite Orange™, Scrub Teal™, and clear for different skin tones.
Acting in the presence of organic matter			Not neutralized by blood or organic matter.³

The BD ChloraPrep™ formulation uses a combination of chlorhexidine and isopropyl alcohol to provide both rapid killing of bacteria and persistent antimicrobial activity.

IPA rapidly kills microorganisms by denaturing cell proteins, while CHG maintains persistent antimicrobial activity by disrupting the cell membrane and precipitating cell contents. Additionally, CHG is able to bind to the skin and retain antimicrobial activity in the presence of blood and other organic material.

“… because the efficacy of any formulation is significantly affected by the excipients present, trials demonstrating activity of one formulation can not be used as evidence for the efficacy of another.”

-Graham W. Denton

Denton G., Chlorhexdine. In: Block S, ed. Disinfection, Sterilisation and Preservation. 5th ed. Lippincott Williams and Wilkins. 2001

BD ChloraPrep™ meets third party evidence-based standards for preoperative skin antiseptic solutions according to leading healthcare organizations. _^4,5,6

Comparison of antimicrobial agents

Active agents	Traditional iodophors	Alcohol
2016	World Health Organization (WHO)⁴	The panel recommends alcohol-based antiseptic solutions based on CHG for surgical skin site preparation.
2016	American College of Surgeons and Surgical Infection Society ⁵	Alcohol-containing preoperative skin preparatory agents should be used unless contraindication exists.
2017	Centers for Disease Control and Prevention(CDC)⁶	Perform intraoperative skin preparation withan alcohol-based antiseptic agent unless contraindicated.

1. Degala, et al. United States Patent 9,078,934. July 14, 2015

2. Beausoleil C, Comstock SL, Werner D, Li L, Eby JM, Zook EC. Antimicrobial persistence of two alcoholic preoperative skin preparation solutions. J Hosp Infect. 2022 Nov;129:8-16

3. Mimoz, O et al. Chlorhexidine compared with povidone-iodine as skin preparation before blood culture. A randomized, controlled trial. Annals of internal medicine vol. 131,11 (1999): 834-7

4. WHO 2016 Global guidelines for the prevention of SSIs fact sheet https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/ssi/fact-sheet-skin-web.pdf?

5. Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, Itani KM, Dellinger EP, Ko CY, Duane TM. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2017 Jan;224(1):59-74

6. Berríos-Torres SI, et al; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017 Aug 1;152(8):784-791.

BD ChloraPrep™ is a rapid-acting and persistent preoperative skin preparation. Its proven formulation is available in six unique applicators designed for the right amount of antiseptic solution for the right procedural area.

Advantages of BD ChloraPrep™ preoperative skin preparation include its broad spectrum, rapid-acting and persistent antimicrobial activity (at least 7 days¹), and effectiveness in the presence of blood and organic matter. These advantages are a result of the unique 2% CHG/70% IPA formulation of BD ChloraPrep™ preoperative skin preparation. Chlorhexidine gluconate, a cationic bisbiguanide, works by destroying the bacterial cell membrane and precipitating cell contents. Alcohol denatures cell proteins. As a result, BD ChloraPrep™ preoperative skin preparation provides better broad spectrum, immediate, cumulative and residual antibacterial activity compared to traditional iodophors. ² ³

Yes. After submitting a new drug application (NDA) to the Food and Drug Administration (FDA), BD ChloraPrep™ preoperative skin preparation received FDA approval in 2000.

When seeking Food and Drug Administration (FDA) approval for an over-the-counter antiseptic, all manufacturers of chlorhexidine-based solutions are required to submit a new drug application (NDA). The review of a NDA by the FDA includes evaluation of clinical, manufacturing and labeling information to assure the product is safe and effective.

Alcohol and iodophors were identified by the FDA as "generally recognized as safe and effective" (GRASE) and are included in the tentative final monograph from the FDA. As a result, manufacturers of alcohol, iodophors and iodine-based solutions can market products without submitting efficacy and safety data and product labeling to the FDA for review prior to marketing and selling their products.

Prepping time varies by the location and size of the prep site and applicator used.

Pinch

• Hold the applicator with the sponge down.

• Pinch the lever only once to activate the ampules and release the antiseptic.

Apply

• Wet the sponge by pressing and releasing the sponge against the treatment/

incision area until liquid is visible on the skin.

• Completely wet the treatment area with antiseptic.

Dry surgical sites (e.g., abdomen or arm)

– Use gentle, repeated back-and-forth strokes for 30 seconds.

Moist surgical sites (e.g., inguinal fold)

– Use gentle, repeated back-and-forth strokes for 2 minutes.

• Do not allow the solution to pool; tuck prep towels to absorb solution, and then remove.

Dry

• For safety and efficacy, allow the solution to completely dry. Follow labeled instructions per applicator package.

Prepping time varies by the location and size of the prep site and applicator. Prepping with BD ChloraPrep™ preoperative skin preparation is a procedure that, compared to the "scrub and paint technique," greatly reduces the amount of time required for patient preoperative skin preparation.

BD ChloraPrep™ preoperative skin preparation is for external use only.

Use with care in premature infants or infants under 2 months of age. These products may cause irritation or chemical burns.

BD ChloraPrep™ should not be used:

On patients with known allergies to chlorhexidine gluconate or isopropyl alcohol
For lumbar puncture or in contact with the meninges
On open skin wounds or as a general skin cleanser
In or around eyes, ears, and mouth. It may cause serious or permanent injury if it is permitted to enter and remain.
For lumbar puncture or in contact with the meninges
On open skin wounds or as a general skin cleanser
In or around eyes, ears, and mouth. It may cause serious or permanent injury if it is permitted to enter and remain.

Additional labeled warnings of BD ChloraPrep™ preoperative skin preparation include:

The Antiseptic Solution contains alcohol and gives off flammable vapors—allow it to dry for three minutes on hairless skin.
Do not drape or use an ignition source (e.g., cautery, laser) until the solution is completely dry (allow it to dry for a minimum of three minutes on hairless skin; up to one hour in hair).
Avoid getting antiseptic solution into hairy areas, as wet hair is flammable. Hair may take up to one hour to dry. Reduced dry time for smaller applicators.
Do not allow the antiseptic solution to pool.
Remove any soaked materials, drapes and gowns before using ignition sources.
Whenever prepping the neck area, place towels under each side to absorb excess antiseptic solution and then remove.

Use with care in premature infants or infants under 2 months of age. These products may cause irritation or chemical burns.

Each BD ChloraPrep™ applicator is appropriate for a variety of procedures, depending on the size of the area that needs to be prepped.

26 mL BD ChloraPrep™ applicator (~13.2 in x ~13.2 in)

10.5 mL BD ChloraPrep™ applicator (~8.4 in x ~8.4 in)

3 mL BD ChloraPrep™ applicator (~4 in x ~5 in)

1 mL and FREPP™ 1.5 mL BD ChloraPrep™ applicators and ChloraPrep™ swabstick (~2.5 in x ~2.5 in)

BD ChloraPrep™ applicators have been designed as convenient single-use, latex-free, hands-off applicators. Designed for a smooth delivery of the appropriate amount of solution for each respective procedure, the packaging for the BD ChloraPrep™ swabstick and the patented glass ampule in the Frepp™, 3 mL, 10.5 mL and 26 mL applicators eliminate the risk of contaminated solution and protect the chlorhexidine gluconate (CHG) molecule from degradation.

Furthermore, BD ChloraPrep™ Frepp™, 3 mL, 10.5 mL and 26 mL applicators each use a patented "wing" design to minimize instances where aseptic technique is compromised.

The tint process for BD ChloraPrep™ Scrub Teal™ and Hi-Lite Orange™ tints is a patented technology that adds color to the solution as it enters the sponge pad. When applied to the skin, each tint allows for easy visualization of the prepped area. Unlike iodine-based preps, which are brown, Scrub Teal™ and Hi-Lite Orange™ tints are easy to see when applied to a variety of skin tones. The dyes in Scrub Teal™ and Hi-Lite Orang™e tints are Food, Drug and Cosmetic (FD&C) Green #3 and Yellow #6 dyes, and have been "generally recognized as safe" (GRAS) by the Food and Drug Administration (FDA). For an ingredient to be listed as GRAS, extensive safety testing is conducted, reviewed and accepted. FD&C Green #3 is a common colorant used in many applications throughout the healthcare field (e.g., eye angiography and screening for ocular dryness, routine lab testing, dye injections, histological/cytological stains for cancer screening of tissues). FD&C Green #3 and Yellow #6 were found to be stable when combined with the 2% chlorhexidine gluconate/70% isopropyl alcohol BD ChloraPrep™ formulation, which offers proven, stable and uncompromised chlorhexidine-based solutions.

It is recommended that BD ChloraPrep™ preoperative skin preparation with tint remain on the skin, especially at the incision site, post-procedure to provide maximum antimicrobial activity. The tints will slowly fade from the skin. If your facility's policies or procedures require clean-up and/or removal of the BD ChloraPrep™ tints, they can be removed with a BD ChloraPrep™ clear applicator, alcohol, or soap and water.

The coverage area is specific to each applicator.

26 mL BD BD ChloraPrep™ applicator: ~13.2 inches x ~13.2 inches

10.5 mL BD BD ChloraPrep™ applicator: ~8.4 inches x ~8.4 inches

3 mL BD BD ChloraPrep™ applicator: ~4 inches x ~5 inches

1mL and FREPP 1.5 mL BD BD ChloraPrep™ applicators and BD ChloraPrep™ swabstick: ~2.5 inches x ~2.5 inches

BD ChloraPrep™ products are labeled with a three-year shelf life from the date of production.

Yes. The full line of BD ChloraPrep™ applicators is available in a wide range of kits and trays. Our trained customer support representatives can work with your facility kit manufacturers to include BD ChloraPrep™ preoperative skin preparation in your current SPT/CPT kits.

Yes. To request samples, contact BD ChloraPrep™ Customer Support at 1.844.8.BD.LIFE (844.823.5433)

Preoperative skin preparation is necessary to limit microorganisms on the skin and help minimize their entry into an incision or device-insertion site after application. Normal skin flora and suboptimal skin antisepsis are the primary drivers of healthcare-associated infections (HAIs).¹

For most SSIs, the source of pathogens is the endogenous flora of the patient’s skin, mucous membranes, or hollow viscera. When mucous membranes or skin is incised, the exposed tissues are at risk for contamination with endogenous flora.⁴ The goal of preoperative patient skin antisepsis is to reduce the patient's risk of developing a surgical site infection by removing soil and transient microorganisms at the surgical site. Reducing the amount of bacteria on the skin near the surgical Incision lowers the risk of contaminating the surgical incision site. Effective skin antiseptics rapidly and persistently remove transient microorganisms and reduce resident microorganisms to sub-pathogenic levels with minimal skin and tissue irritation.⁵

Surgical skin preparation aims to reduce the bacteria on the skin that may cause infection through the cleaning of the patient’s skin.⁶

Clipping hair before surgery isn’t just messy—the loose hair can increase the potential risk of contamination to your patients. Potentially contaminated hair on linens, wheels and the floor can migrate into the OR and elsewhere in the facility.

Cleaning the skin before surgery reduces the amount of bacteria and microorganisms present that may cause surgical site infections. Follow antiseptic solution package inserts for optimal efficacy with regards to following prep time, application process, dry time, and warnings/contraindications.

Alcohol-based preoperative skin antiseptic solutions are recommended in the evidence-based infection prevention guidelines published by preeminent health organizations:

● American College of Surgeons/Surgical Infection Society (ACS/SIS): Alcohol-containing preoperative skin preparatory agents should be used unless contraindication exists. (2016)⁷

● Centers for Disease Control and Prevention (CDC): Perform intraoperative skin preparation with an alcohol-based antiseptic agent unless contraindicated. (2017)⁸

● World Health Organization (WHO): The panel recommends alcohol-based antiseptic solutions based on CHG for surgical skin site preparation.⁶

● Society for Healthcare Epidemiology of America (SHEA): Use an alcohol based antiseptic for skin preparation.⁹

A comparison of patient preoperative skin antiseptic solutions

	Alcohol	Iodophors (iodine-based)	CHG	Iodine+ alcohol	BD PurPrep™ patient preoperative skin preparation with sterile solution	CHG+ alcohol	BD ChloraPrep™ patient preoperative skin preparation with sterile solution
Broad spectrum9-12	X	X	X	X	X	X	X
Fast acting9-12	X			X	X	X	X
Persistent9-12			X	X	X	X	X
Acting in the presence or organic matter 9-12			X			X	X
Minimizes the risk of Intrinsic contamination1B					X		X

○ PVP-I allows for the free iodine to be released, which destroys proteins and DNA of microorganisms.

○ This solution is often used, since it is safe to use on most skin regardless of age.

○ CHG breaks down bacteria cell membranes to disinfect the skin.

○ The combination of fast-acting and persistent antimicrobial

IPA alone provides a 99.99% reduction in bacteria, but it does not provide long-lasting microbial kill. BD ChloraPrep™ maintains antimicrobial activity, demonstrating persistence for at least 7 days¹ compared to two hours for free iodine. Because BD ChloraPrep™ preoperative skin preparation contains the combination of isopropyl alcohol and chlorhexidine, it is more effective than isopropyl alcohol alone.

○ The chlorhexidine bisbiguanide groupings associate strongly to exposed anionic sites on the cell wall and cell membrane, particularly acidic phospholipids and proteins, causing displacement of divalent cations (Ca2+ and Mg2+). Bridging adjacent phospholipids in the cell membrane will cause a loss of structural integrity, reduce membrane fluidity and allow leakage of cellular materials.¹³

○ Bacterial cells are negatively charged, but in the presence of chlorhexidine, the bacterial cell is neutralized and the charge is reversed. The attraction of the cationic chlorhexidine molecule and the negatively charged bacterial cell contributes to a rapid rate of bacterial kill; surface charge reversal is secondary to cell death.³

○ In contrast, traditional iodophors can take two to three minutes until the free release of iodine can occur. While the iodophor dries, free iodine becomes available. The iodine then attacks the bacterial cell and the oxidation of two sulfhydryl groups, resulting in the formation of a disulfide bond. The effectiveness of iodophors is ≤ three hours. Lastly, iodophors are neutralized in the presence of blood and organic matter and have greater irritation than the CHG solution.¹⁴

○ Chlorhexidine-based antiseptics have been used globally for more than 50 years and have been widely used in the US, Europe, Canada and Japan for more than 30 years. In the United States alone, more than 100 studies (excluding those focused on hand hygiene data) have been published, revealing positive outcomes related to the use of chlorhexidine gluconate (CHG)-based antiseptics. There are over 60+ published studies specifically for BD ChloraPrep™ preoperative skin preparation.

The combination of fast-acting and long-lasting antimicrobial activity is the key to an effective preoperative skin preparation. IPA alone provides a 99.99% reduction in bacteria, but it does not provide long-lasting microbial kill. BD ChloraPrep™ maintains antimicrobial activity for at least 7 days¹ compared to two hours for free iodine.³ Because BD ChloraPrep™ preoperative skin preparation contains the combination of isopropyl alcohol and chlorhexidine, it is more effective than isopropyl alcohol alone.

There are a number of reasons why skin preparation prior to surgery matters. Effectively preparing the skin can reduce the microorganisms on the skin that may cause surgical site infections. Below are some of the risk factors:

● On a single square centimeter of skin, there can be as many as 10 million aerobic bacteria¹⁵

● 80% of microorganisms reside in the first five cell layers of the epidermis¹⁶

● Infection prevention measures have focused on asepsis of healthcare providers and the environment, but there is evidence about the role played by the patient's own skin⁸

Skin preparation solutions designed to reduce microorganisms on the skin before surgical procedures may contribute to contamination when nonsterile antiseptic solutions are used. According to the FDA, intrinsic contamination “may occur during the manufacturing process”.¹⁷ Infections from intrinsic contamination of antiseptics have been well documented.¹⁸ ¹⁹ Because of intrinsic contamination risks, the FDA requested that manufacturers label topical antiseptic solutions as sterile or nonsterile.¹⁷ Sterilizing the antiseptic solution during production can minimize potential intrinsic bacterial threats. However, most U.S. manufacturers of commercially available antiseptic skin preparations have not adopted this technologically challenging process. BD overcame this challenge, developing a patented process to sterilize antiseptic solutions within sealed containers to provide sterility assurance. In summary:

● Antiseptics do not self-sterilize ²º

● All commonly used antiseptic agents have been linked to infection-causing contamination.¹⁹

● Outcomes associated with contaminated antiseptics may be underreported for a range of reasons.

Disposal of the contaminated product before infection is discovered¹⁸
Inconsistent contamination within the same product lot¹⁸

BD offers an exclusive portfolio of fully sterile skin prep applicator products.

BD has a number of tools and products aimed at helping reduce bacteria on the skin that may cause infections.

One study compared the removal of dispersed hair using standard surgical clippers with surgical tape vs clippers fitted with the ClipVac™ Hair Removal System. The study assessed clipping duration and the amount of loose hair and microbial contamination following clipping.²¹
- Faster clipping and cleanup time: Using BD clippers with the ClipVac™ System resulted in an average of 40% faster clipping and cleanup time compared to clippers and adhesive tape.
- Reduced contamination: Using clippers and the ClipVac™ System significantly reduced the amount of microbial contamination, by an average of 85%, compared to clipping and tape cleanup.
- Less residual loose hair: Clipping with the ClipVac™ System was highly effective in reducing the dispersion of contaminated hair fibers within areas adjacent to the skin-prep site vs clipping followed by tape cleanup.

● Adhesive tapes, commonly used for hair cleanup, are not sterilized or kept under controlled conditions, and may become colonized with organisms and contribute to HAIs.²²

● The same adhesive tape rolls are frequently used on multiple patients, often containing hair from previous patients.

● AORN guidelines recommend that body hair be removed when it may interfere with surgery, and that hair removal should limit particle dispersion.²³

○ BD’s durable, efficient surgical clippers support patient preoperative hair removal in a single pass and minimize the risk of compromising the skin. Our clippers remove more hair per second than 3M™, Cardinal Health™, and Medline™ in internal laboratory tests²⁴, saving valuable OR patient-prep time. They also offer the following benefits:

A close cut while maintaining skin integrity
A 40° angled, ergonomic handle, allowing seamless preoperative hair removal
Usability in either wet or dry clipping conditions
The only IXP-7 waterproof-rated clippers for submersibility, to support thorough cleaning and disinfecting
Lithium-ion battery technology to facilitate longer runtime and improve energy efficiency
Battery-life and charging indicators that alert clinicians to charge level
Choice of three blades for a variety of procedures

○ BD ChloraPrep™ is a rapid-acting and persistent preoperative skin preparation. Its proven formulation is available in six unique applicators designed for the right amount of solution for the right procedural area.

○ Advantages of BD ChloraPrep™ preoperative skin preparation include its broad spectrum, rapid-acting and persistent antimicrobial activity (7 days¹) and effectiveness in the presence of blood and organic matter. These advantages are a result of the unique 2% CHG/70% IPA formulation of BD ChloraPrep™ preoperative skin preparation. Chlorhexidine gluconate, a cationic bisbiguanide, works by destroying the bacterial cell membrane and precipitating cell contents. Alcohol denatures cell proteins. As a result, BD ChloraPrep™ preoperative skin preparation provides better broad spectrum, immediate, cumulative and residual antibacterial activity compared to traditional iodophors. ² ³

BD PurPrep™ Patient Preoperative Skin Preparation with Sterile Solution is the first and only fully sterile povidone-iodine (PVP-I) plus isopropyl alcohol (IPA) in applicator form available in the United States.

BD E-Z Scrub™ preoperative surgical scrub brushes are single-packaged brushes impregnated with a wide range of antimicrobial formulations. These formulations include chlorhexidine gluconate (CHG), chloroxylenol (PCMX), and povidone-iodine (PVP-I)

These unique sponges are not only designed to be comfortable and gentle on the skin, they are uniquely formulated to help meet CDC and WHO guidelines for cleaning hands before putting on gloves or contacting patients.²⁵

This information only pertains to U.S. solutions.

Beausoleil C, Comstock SL, Werner D, Li L, Eby JM, Zook EC. Antimicrobial persistence of two alcoholic preoperative skin preparation solutions. J Hosp Infect. 2022 Nov;129:8-16.
Hemani ML, Lepor H. Skin preparation for the prevention of surgical site infection: which agent is best? Rev Urol. 2009 Fall;11(4):190-5
Denton GW. Chlorhexidine. Disinfection, sterilization, and preservation. (Edited by S.S. Block, 4th ed) Philadelphia: Lea & Feabiger. 1991. pp. 322–333.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999 Apr;27(2):97-132
2021 AORN Guidelines for Perioperative Practice: Patient Skin Antisepsis
WHO 2016 Global guidelines for the prevention of SSIs fact sheet https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/ssi/fact-sheet-skin-web.pdf?sfvrsn=ead06f37_2#:~:text=Surgical%20site%20skin%20preparation%20is,the%20operating%20room%20(OR).
Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, Itani KM, Dellinger EP, Ko CY, Duane TM. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2017 Jan;224(1):59-74
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Data on File
2009 WHO Hand Hygiene Guidelines

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