2026 SICOT Annual Meeting: Effectiveness of Preoperative Skin Cleansing for Bacterial Contamination during Arthroscopic Shoulder and Knee Procedures: A Randomized Controlled Trial

148 patients undergoing arthroscopic rotator cuff repair (ARCR), arthroscopic Bankart repair (ABR), or anterior cruciate ligament reconstruction (ACLR) were randomized to receive preoperative cleansing with 4% chlorhexidine gluconate (CH) (n=74) or nonbactericidal wet towel wiping (WT) (n=74). The primary outcomes of interest were surgical site infection (SSI) and bacterial contamination, assessed using intraoperative suture cultures and postoperative adhesive tape cultures. Outcomes were assessed during surgery and postoperatively, with SSI surveillance continuing for 24 months. Overall, the results revealed no SSIs in either group, while tape culture positivity was significantly lower with CH than WT (14.9% vs 28.4%; p=0.046). Suture culture positivity did not differ significantly between groups (20.3% vs 29.7%; p=0.184), and contamination was substantially more common in shoulder than knee procedures. These findings suggest that preoperative 4% CH cleansing may reduce bacterial contamination during arthroscopic surgery, particularly in procedures with a greater contamination burden.