The frequency of rectal
infections is increased in patients with acute
leukemia. Complications associated with rectal lesions may be severe enough to cause life-threatening
septicemia. Clinical research evaluating the effects of preventive perirectal
skin care is scarce. This study's purpose was to determine whether using
chlorhexidine gluconate (CHG) in a prophylactic perirectal
skin-care regimen decreases perirectal
infections and whether it produces more skin irritation than a nonmedicated skin cleanser. The sample consisted of 40 patients, 16 of whom were randomized to use
chlorhexidine and 24 of whom were randomized to use nonmedicated skin cleanser. Chi-square and t-tests were used to analyze the incidence of skin breakdown and rectal
infections; the correlation between the two factors; a positive history of rectal
infections, fissures, or
hemorrhoids; presence of
hemorrhoids; severity of
diarrhea; and duration and severity of
granulocytopenia. A positive relationship was found between the severity of
granulocytopenia and the incidence of rectal
infections (p = 0.02). No significant difference was seen in the occurrence of perirectal
infections (p = 0.35) or skin breakdown (p = 0.18) between the two groups. The data suggest that CHG does not offer increased protection against perirectal
infections in patients undergoing intensive
chemotherapy, nor is it more irritating than a nonmedicated skin cleanser. Further studies are needed to examine the efficacy of hygienic measures such as using skin
disinfectants to prevent
infections in patients who are immunocompromised.