Aim: To assess the effectiveness of povidone-iodine alcoholic tincture and the alcoholic chlorhexidine gluconate solution in the eradication of bacteria in forefoot surgery, and to assess any added benefits with the use of surgical bristles.

Methods: Fifty consecutive patients were prospectively enrolled into the study and randomised to receive one of two surgical skin preparations.

Results: The use of povidone-iodine with prior surgical scrubbing had a better eradication rate compared to povidone-iodine alone in the interdigital web-spaces. Prior surgical scrubbing with both solutions had a better eradication rate for the skin over the 1st metatarso-phalangeal joints. But neither solution with or without the use of surgical scrubbing was superior at eradicating organisms from the medial hallucal fold. However none of these results were statistically significant. None of the patients developed any post-operative wound infection.

Conclusions: Our results did not show any statistically significant advantage with either solution nor was there any apparent advantage with the use of the surgical scrub prior to the skin preparation. The authors believe that eradication of bacteria in forefoot surgery is dependant on a meticulous and methodical skin preparation technique and less so on the solution used and method of application.