Chlorhexidine Gluconate Stick: Clinical Utility and Best Practices
- Mayta
- 6 hours ago
- 2 min read
Overview
The Chlorhexidine Gluconate (CHG) Stick is a single-use, cotton-tipped applicator containing chlorhexidine gluconate in various concentrations, depending on clinical use. Activation by snapping or squeezing the plastic shaft saturates the tip, allowing immediate antiseptic application.
Formulations:
2% CHG in 70% isopropyl alcohol: For intact skin antisepsis.
0.5% aqueous CHG: For wound care.
0.12% CHG: For oral care in ventilated patients.
Why CHG Sticks Are Favoured
Rapid, Broad-Spectrum Antimicrobial Action:CHG kills most Gram-positive and Gram-negative bacteria, many viruses, and yeasts within 20–30 seconds.
Persistent Protection:CHG binds to keratin in the stratum corneum, maintaining antimicrobial activity for up to six hours, surpassing the efficacy window of povidone-iodine.
Guideline-Supported First-Line Agent:Major infection prevention guidelines, including CDC, WHO, and others, recommend CHG–alcohol combinations for:
Central line insertion
Surgical site preparation
Bedside procedures like lumbar punctures and minor surgical interventions
Common Clinical Uses (Mnemonic: C-H-L-O-R-H-E-X)
C: Central venous catheter insertion
H: Hospital surgical skin preparation
L: Line access (IV, PICC, dialysis)
O: Oral care for ventilated patients (using 0.12% solution)
R: Reduction of wound bioburden (selected chronic ulcers)
H: Hemostasis sites & minor procedures (e.g., biopsy, suturing)
E: Epidural/spinal anesthesia puncture site antisepsis
X: Xcellent antimicrobial protection for catheter sites
Step-by-Step Usage Guide
Site Preparation:
Remove visible dirt and debris.
Dry the area thoroughly.
Don clean gloves.
Activation:
Snap or squeeze the plastic shaft.
Ensure the tip becomes fully saturated.
Application:
Use firm back-and-forth strokes.
Cover a field wider than the planned incision or puncture site.
Allow to Air-Dry (≥30 seconds):
Do not blot.
Air-drying permits binding of CHG to keratin and prevents chemical burns under occlusive drapes.
Safety Considerations and Precautions
Allergy and Anaphylaxis:
Always screen for past allergic reactions to antiseptics.
Severe anaphylactic reactions, while rare, have been documented.
Special Populations:
Mucous membranes: Only use low-strength (≤0.12%) formulations.
Neonates: Avoid CHG, especially <2 months old, due to chemical burn risk.
Eye and Ear Exposure:
CHG is toxic to corneal tissue and the middle ear; strict avoidance is mandatory.
Inactivation:
Soap residues and heavy organic matter can inactivate CHG. Rinse the area and reapply if contamination occurs.
CHG vs Povidone-Iodine: Key Differences
Feature | CHG Stick | Povidone-Iodine |
Speed | Acts within 30 seconds | Requires ≥2 minutes contact |
Persistence | Continues working for hours | Activity ends once dry |
Skin Tolerance | Less dermatitis and staining | Higher risk of dermatitis |
Combination with Alcohol | Synergistic and superior infection prevention | Less effective |
Storage and Shelf Life
Storage Conditions:Keep in foil pouches at 15–30°C (59–86°F), shielded from direct sunlight.
Discard If:
Solution becomes cloudy.
The tip dries out.
Pouch integrity is compromised.
Bottom Line
Chlorhexidine sticks offer fast, reliable, and long-lasting skin antisepsis. Proper use — emphasizing activation, wide-area application, and sufficient air-drying — ensures their full protective potential. Their safety profile and superior efficacy make them the gold standard for preparing central-line sites, surgical fields, and many bedside procedures.
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