Single vs Repeat Surgical Skin Preparations for Reducing Surgical Site Infection After Total Joint Arthroplasty: A Prospective, Randomized, Double-Blinded Study

600 patients undergoing primary total joint arthroplasty (TJA) were randomized to receive two applications of surgical site preparation solutions (SPS), one before and one after standard draping, or to a control group that received a single application of SPS before standard draping. The purpose of this study was to determine whether the reapplication of SPS provided a greater reduction of SSI compared to the traditional single application. Outcomes included the rates of SSI (superficial, deep, and organ-space) followed up in the SPS reapplication group for an average of 37.5 months and in the control group for an average of 39.7 months, and skin blistering assessed on the first day postoperatively. The findings demonstrated a significant reduction in the rate of superficial SSI in the SPS reapplication group compared to the control group. The reduction in skin blistering favoured the SPS reapplication group compared to the control group, but differences were not statistically significant.