Introduction: Surgical site infection (SSI) is a serious surgical treatment complication, which can have a significant effect on treatment success. Moreover, treatment of such infections can also present a great financial burden. Optimal surgical site preparation is therefore a crucial factor in preventing these infections. Purpose: The purpose of this diploma work is to describe the preoperative preparation of a sterile surgical field. Specifically, three phases of the preparation were described in more detail: preoperative wash (shower), skin disinfection and hair removal in the preoperative field. The goal was to answer the following questions: is preoperative wash with chlorhexidine soap really more effective than normal soap; is chlorhexidine gluconate (CHG) really the optimal skin antiseptic for all types of surgeries and how should it be prepared (CHG percentage and type of solution) for its greatest efficacy; and, finally, what is the most optimal hair removal procedure in the preoperative field. Methods: A descriptive method of work was used, more specifically, a review of scientific literature in Slovene and English, with an emphasis on recent literature (published after 2009). In the search, the following databases were used: Medline, COBIB, Science Direct and CINAHL. Some literature sources were acquired by hand. Keywords were determined before the beginning of the literature search. Results: There is no clear answer whether chlorhexidine wash actually reduces surgical site infections more effectively than normal soap. Hair removal is not recommended for routine use; if required, a clipper should be used. Two-percent CHG in 70-percent alcohol solution is used as a preferable antiseptic solution (considering certain safety hazards recommendations), with povidone-iodine (PVI) in alcohol solution as its alternative. Discussion and conclusion: There is a need for an effective, well-defined chlorhexidine soap wash regime, whose efficacy would be fully tested in the future (the time and frequency of wash, the duration of chlorhexidine interaction with the skin prior to rinsing). Chlorhexidine gluconate in an alcohol solution can cause damage to the eyes, ears and neuromeningeal structures; therefore, it needs to be used carefully and in accordance with recommendations. With that in mind, chlorhexidine gluconate is still considered as the most optimal preoperative skin antiseptic. In some types of surgery, specifically those in which complicated bacterial flora is frequently isolated (i.e. surgeries in the shoulder region, where Cutibacterium acnes are commonly found), routinely used skin antiseptics have a significantly lesser effect on SSI prevention.
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