Comparison of efficacy of chlorhexidine alcohol with povidone iodine for prevention of surgical site infection: a prospective study

Authors

  • Binni John Department of General Surgery, Medical College, Kottayam, Kerala, India
  • Rajith Kishore K. K. Department of General Surgery, Medical College, Kottayam, Kerala, India
  • Vipinchandran C. Department of General Surgery, Medical College, Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20181480

Keywords:

Chlorhexidine-alcohol, Povidone iodine, Surgical site infections

Abstract

Background: Surgical site infections (SSI’s)are the major risk factors of postoperative morbidity and mortality. The incidence of these SSI’scan be minimized by taking prophylactic measures such as using effective preoperative antiseptics such as chlorhexidine (CHG) or povidone-iodine (PVI). The aim of the present study was to compare the efficacy of 2.5% chlorhexidine-alcohol with that of 10% povidone iodine for preventing SSI’sin clean contaminated elective surgeries.

Methods: This prospective study included 100 patients who were undergoing for clean contaminated elective surgeries at Government Medical College, Kottayam from April 2014 to September 2015. Group A included 50 patients in which 2.5% chlorhexidine alcohol (chlorhexidine 2.5% in 70% ethanol) was used for preoperative skin cleansing and Group B included 50 patients in which 10%povidone-iodine aqueous was used. Incidence of SSI’s in terms of efficacy was compared between the groups.

Results: Female preponderance was seen in both the groups, but the difference was not significant statistically. The SSI’swere seen in 5 patients in group A and in 12 patients in group B and this difference was found statistically significant (p=0.0084).Out of 5, in group A, 3 sites were culture positive showing the presence of S. aureus culture in 1 case and E. coli in 2 cases and in group B, out of 12, 6 sites were culture positive consisting of S. aureus and E. coli in 3 cases each.

Conclusions: Chlorhexidine (2.5%) significantly reduced the risk of postoperative SSIs and colonization of bacteria in elective surgeries when compared to 10% povidone iodine.

References

Brunicardi CF, Andersen DK. Schwartz's manual of surgery. 10th ed. New York, NY: McGraw-Hill; 2010

Astagbeau P, Riox C, Golliot F, Brucker G. INCISCO "Network Study Group. Morbidity and mortality associated with surgical site infections: results from the 1997-1999 INCISO surveillance. J Hosp Infect. 2001;48(4):267-74.

Kirkland KB, Briggs JP, Trivette SL, Wilkinson SE, Sexton DJ. The impact of surgical site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control HospEpidemiol 1999;20(11):725-30.

Yasunage H, Ide H, Imamura T, Ohe K. Accuracy of economic studies on surgical site infection. J Hosp Infect. 2007;65(2):102-7.

Green JW, Wenzel RP. Postoperative wound infection: a controlled study of the increased duration of hospital stay and direct cost of hospitalization. Ann Surg. 1977;185(3):264-8.

Kulaylat MN, Dayton MT. Surgical Complications. Sabiston Textbook of Surgery. Volume 1. 19th Ed. Philadelphia, PA: Elsevier Saunders; 2012.

Dumville JC, McFarlane E, Edwards P,Lipp A, Holmes A. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database Syst Rev. 2015; CD003949.

Anderson C, Uman G, Pigazzi A. Oncologic outcomes of laparoscopic surgery for rectal cancer: a systematic review and meta-analysis of the literature. Eur J Surg Oncol. 2008;34(10):1135-42.

Davies BM, Patel HC. Does chlorhexidine and povidone-iodine preoperative antisepsis reduce surgical site infection in cranial neurosurgery? Ann R Coll Surg Engl. 2016;98(6):405-8.

Paocharoen V, Mingmalairak C, Apisarnthanarak A. Comparison of surgical wound infection after preoperative skin preparation with 4% chlorhexidine [correction of chlohexidine] and povidone iodine: a prospective randomized trial. J Med Assoc Thai. 2009;92(7):898-902.

Downloads

Published

2018-04-21

Issue

Section

Original Research Articles