The recommendations in this document thus supersede the previous WHO recommendations for choice of antiseptic agent and method of application for preoperative skin preparation for caesarean section as published in the 2015 guideline WHO recommendations for prevention and treatment of maternal peripartum infections.
The primary audience for this recommendation includes health professionals who are responsible for developing national and local health-care guidelines and protocols (particularly those related to the prevention and treatment of peripartum infections) and those involved in the provision of care to women and their newborns during labour and childbirth, including midwives, nurses, general medical practitioners and obstetricians, as well as managers of maternal and child health programmes, and relevant staff in ministries of health and training institutions, in all settings.
Summary of clarifying remarks:
- There was a lack of evidence to recommend a specific concentration of chlorhexidine gluconate; however, most trials included used 2% chlorhexidine gluconate in 70% alcohol.
- Where chlorhexidine gluconate is not available, other antiseptic agent such as povidone-iodine can be considered a suitable antiseptic agent for preoperative skin preparation, although it is not as effective as alcohol-based chlorhexidine gluconate.
- A standard preoperative skin preparation technique that is appropriate for the intended skin incision must be followed (e.g., allow antiseptic agent to dry and not wiping off).