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Skin Preparation for Injections: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines

Last updated: April 16, 2020
Project Number: RC1218-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of skin preparation prior to injections in patients eligible for injections?
  2. What is the cost-effectiveness of skin preparation prior to injections in patients eligible for injections?
  3. What are the evidence-based guidelines for preparing the skin for injection?

Key Message

One relevant randomized controlled trial was identified regarding the effectiveness of skin preparation prior to vaccinations in children. The study found that there was no statistically significant difference in local skin reactions and infection rates when comparing alcohol skin cleansing to no cleansing prior to vaccinations. The duration of pain was statically significantly higher in the alcohol swab group compared to the control group. There were no identified cases of cellulitis, pus leaking and infectious abscess. However, the study was insufficiently powered to detect a difference in the primary outcome of skin infection. Due to the limitations of the study it is difficult to draw sound conclusions of whether alcohol swabbing reduces infection rates compared to no swabbing. No cost-effectiveness studies or evidence-based guidelines were identified regarding skin preparation prior to injection.