Treatment in the Hospital with CHG (2% Chlorhexidine Gluconate) Cloths

Important information about CHG treatment:

Preventing infections during your child’s hospital stay is very important to us. Using CHG is one way to help prevent infections.

CHG cloths are like baby wipes, but contain CHG, an antibacterial product that is even more effective than regular soap for cleaning the skin. Studies have shown that CHG cloths decrease the risk for certain infections.

Do not use CHG if your child:

• Is allergic to chlorhexidine gluconate. There are several forms of CHG. Please ask the medical team if one will be safe for your child.

• Is an infant born less than full term (less than 37 weeks gestational or corrected age).

• Has severe skin conditions or skin burns.

• Receives thiotepa or total body irradiation. They cannot use CHG during and for 24 hours after treatment.

• Is admitted for MIBG infusion. They cannot use CHG for the length of admission.

• Has an unrepaired open spinal defect (for example, myelomeningocele).

If your child has sensitive skin or any skin problems, or if you have any questions, please ask your healthcare team for other antiseptic treatment options.

Who should use CHG cloths?

• Your child must be full term (greater than 37 weeks gestational or corrected age) to use the CHG cloths unless directed by your child’s healthcare team.

• All patients with central lines.

• All patients scheduled for certain types of surgery/central line placement.

How often should CHG cloths be used?

• If your child has a central line, routine hygiene with CHG is performed at least every 24 hours. In addition, if a soap and water bath or shampoo is performed at any other time, CHG should be repeated within one hour.

• The night before and the day of surgery for certain procedures.

• The morning of central line placement.

Instructions for using CHG cloths:

You can perform the treatment or assist the nurse in giving your child the CHG treatment. After reading the instructions below, please contact your child’s nurse with any questions.

1. A daily soap and water bath and shampoo is optional. If you choose to perform a soap and water bath or shampoo, you must do a CHG treatment afterwards.

2. After a soap and water bath or shampoo, do not apply lotions, creams, powder or other skin products to your child’s skin. Let the skin completely dry and cool.

3. Open the CHG package(s) and remove the cloths. Leave the CHG cloths on the blue insulating foam and place on a clean surface.

4. Rub each CHG cloth against itself before using. This brings the CHG to the surface of the cloth and makes it easier to apply.

5. Use a circular and back and forth motion with friction/light pressure to wash your child’s skin. Start at their chin and work your way down the body. Do not use CHG cloths on the head or face.

6. Use the instructions below to decide:

   • The number of CHG cloths to use (based on your child’s weight).

   • The order and body site to clean.

7. Do not rinse your child’s skin. Allow your child’s skin to air dry before dressing in clean pajamas.

8. It is normal for your child to feel “sticky” for several minutes after cleaning. There may be some itching or redness after using the wipes. This should go away quickly. If the redness or itching does not go away after 10 minutes, rinse off and stop using the wipes. Call your child’s healthcare provider if you have any questions.

9. The CHG cloths contain moisturizers to prevent dry skin. After you have used the CHG cloths, do not apply lotions, moisturizers, deodorants, or powders. If you need to apply a product, only approved CHG compatible products may be used. The CHG works best when left on clean, dry skin.

10. Put clean sheets and pillowcases on your child’s bed each day when they use CHG.

Directions for children less than 22 lbs (10 kg)

Requires 2 cloths

Cloth 1: Chest, both arms, back, neck*

Cloth 2: Both legs, buttocks, groin area – do not use cloth on inner labial folds, tip of penis or anus

*Armpit, back of the knees and the groin area have the most bacteria. Use the applicable cloth number based on your child’s weight to clean these areas last.

Instructions for children 22-66 lbs (10 –30 kg)

Requires 4 cloths

Cloth 1: Chest, both arms, neck*

Cloth 2: Both legs*

Cloth 3: Groin area – do not use cloth on inner labial folds, tip of penis or anus

Cloth 4: Back, buttocks

*Armpit, back of the knees and the groin area have the most bacteria. Use the applicable cloth number based on your child’s weight to clean these areas last.

Instructions for children over 66 lbs (30 kg)

Requires: 6 cloths

Cloth 1: Chest, both arms, neck*

Cloth 2: Right leg*

Cloth 3: Left leg*

Cloth 4: Groin area – do not use cloth on inner labial folds, tip of penis or anus

Cloth 5: Back

Cloth 6: Buttocks

*Armpit, back of the knees and the groin area have the most bacteria. Use the applicable cloth number based on your child’s weight to clean these areas last.

Pictures adapted with permission from Children’s Hospital and Clinics of Minnesota

For questions or concerns, contact a member of your child’s healthcare team.

Reviewed May 2024 by Stephen Noll, BSN, RN, CCRN, Catherine Murtaugh, BSN, RN, CPHQ