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CSAC is a surgical antisepsis protocol consisting of a two-step application of chlorhexidine: first as a chlorhexidine-based soap and then as an alcohol-based chlorhexidine solution. It is used for preoperative skin preparation to prevent bacterial colonization and surgical site infections (SSI), particularly in orthopedic procedures. The protocol was evaluated in a randomized clinical trial by the Universidade do Vale do Sapucaí in Brazil, where it was compared to a three-step protocol (CSAAC) that included an intermediate 70% ethyl alcohol step. Chlorhexidine acts as an antiseptic by targeting bacterial cell membranes, leading to the disruption of microbial integrity and cell death.
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