Crashing Slowly

Michelle, thanks so much for listening and for this opportunity to comment. Due to editing of the segment you didn't get to hear all of my thoughts on this issue, so I will share some of them here.
Firstly, and I am sure Dr. Kantor would agree, I wouldn't suggest actually rubbing chlorhexidine (or any other bactericidal agent) within a wound. I agree with you, it would likely be (at least in theory) detrimental for wound healing. I would suggest using this agent around the margins of a wound on intact skin, but not within, so as to prevent introduction of more bacteria within the wound (such as when you drive the suture needle in to the surrounding skin).
In truth, I don’t strongly favor chlorhexidine over betadine. On any given day, I am more likely to use whatever is readily available. This is because, as Dr. Kantor said, there is no evidence that one is better than the other--and due to the low baseline rates of wound infection, such a study will likely never be generated. I do tend to favor chlorhexidine simply for the sake of convenience: when the repair is done, I don’t have to deal with the extra step of going back to remove the unsightly orange betadine from the wound (which can sometimes put the sutures at risk for dehiscence).
Finally, to address your questions regarding these specialty products, I can’t say I personally have any experience with them. My quick scan of the literature surrounding these products certainly doesn’t have me convinced they are any better and I imagine they are probably more expensive. However, it once again boils down to a simple issue: availability. I am guessing most pit docs and PAs in the ER setting don’t stock Prontosan in their wound carts, but correct me if I am wrong.

Great questions by the way. You certainly know your stuff!