Simple, sterile skin disinfection

Yes, HEXI PREP has been evaluated by the Association for Safe Aseptic Practice and has been approved for using within the ANTT® process for both Standard-ANTT and Surgical-ANTT procedures.

HEXI PREP is a 2% Chlorhexidine Digluconate in 70% Isopropyl Alcohol formulation which are the same two chemical entities that are used in other licensed skin antisepsis products in the UK.

1.5ml HEXI PREP CHEX15 procedures include: - Blood culture collection - Peripheral cannulation - Peripheral arterial line cannulation - Simple biopsy - Routine venepunctures - Dialysis/ fistula/ graft site cleansing.

3.0ml HEXI PREP CHEX30 procedures include: - Blood culture collection - Peripheral cannulation - Peripheral arterial line cannulation - Simple biopsy - Routine venepunctures - Dialysis/fistula/graft site cleansing - Midline, CVC insertions and maintenance - Peritoneal dialysis site cleansing - Implantable device placement.

Yes, HEXI PREP can be included into a cannulation pack providing the kit packing company can work with pharmaceutical products and that the secondary sterilisation methods are EtO.

Folded CHEX15 measures 5cm x 2.2cm and CHEX30 measures 5cm x 3cm and unfolded the pad measures 10cm x 10cm and CHEX30 measures 20cm x 10cm.

The SmPC states that the pad should be applied with firm pressure. However, fragile, delicate skin requires gentle pressure to avoid further damage being inflicted during the antisepsis procedure. Therefore, clinical assessment of the fragility of the skin should dictate how much pressure can safely be applied when conducting the antisepsis regime.

HEXI PREP has been evaluated by the Association for Safe Aseptic Practice for use with the Standard-ANTT and Surgical-ANTT procedures.

The marketing authorisation approval from the MHRA also makes it clear that the product can be used for disinfection of the skin prior to invasive medical procedures that do not require a clean air environment, whether as part of a sterile procedure or a non-sterile procedure. There is a different method of applying the product when performed as part of a sterile procedure and so this should be noted from the SmPC.

• HEXI PREP may be used on all age groups and patient populations. However, it should be used with care in newborn babies, especially those born prematurely.
• The use of chlorhexidine solutions, both alcohol based and aqueous, for skin antisepsis prior to invasive medical procedures has been associated with chemical burns in neonates. Based on available case reports and the published literature, this risk appears to be higher in preterm infants, especially those born before 32 weeks of gestation and within the first 2 weeks of life.

If the pad is dry and you cannot apply a wet solution onto the skin for 30 seconds, then following the aseptic procedures use another HEXI PREP to ensure that the disinfection process is completed.

In the case of HEXI PREP during its manufacture the substrate and flow wrap are Gamma sterilised. The product is produced in a Class I clean room under pharmaceutical conditions where the sterile formula is added before the sachets are sealed. This ensures that the HEXI PREP is sterile inside the sealed flow wrap and is protected from potential contamination.

30 seconds is the recommended time for drying, however ambient room temperatures can differ which may speed up or delay drying depending upon the conditions.

HEXI PREP CHEX15 covers 10cm x 10cm of skin, while HEXI PREP CHEX30 covers 15cm x 15cm of skin.

• EPIC 3 guidelines: IVAD15 recommends using a 2% chlorhexidine digluconate in 70% IPA to disinfect areas of a patients’ skin prior to invasive procedures.
• NICE recommends:
  1. General asepsis where an aseptic technique must be used for vascular access device catheter site care and when accessing the system.
  2. Vascular access device site care you must decontaminate the skin at the insertion site with chlorhexidine gluconate in 70% alcohol before inserting a peripheral vascular access device or a peripherally inserted central catheter.

HEXI PREP is manufactured under pharmaceutical conditions in a class I clean room environment. Its fundamental parts are Gamma sterilised and the product is licensed and graded as a pharmaceutical skin antisepsis product approved by the MHRA. CA2CSKIN is made using the same formulation but has none of the sterile features nor is it classed as a pharmaceutical product by the MHRA.

The pad should be used folded as it reduces the potential of air particulate contamination and is less likely to dry out than if it is used unfolded.

One sachet is sufficient to disinfect the skin for each of the indications. 1.5ml CHEX15 covers 10cm x 10cm and is suitable for all indicated peripheral procedures, whereas the 3ml CHEX30 is suitable for 15cm x 15cm of skin disinfection.

HEXI PREP should be used folded as soon as the pad is removed from the sterile packaging and applied to the skin using a cross hatch pattern, back and forth for 30 seconds.

HEXI PREP contains chlorhexidine. Chlorhexidine is known to induce hypersensitivity, including generalised allergic reactions and anaphylactic shock. The prevalence of chlorhexidine hypersensitivity is not known, but available literature suggests this is likely to be very rare. HEXI PREP should not be administered to anyone with a potential history of an allergic reaction to a chlorhexidine-containing compound.