Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery.
METHODS
Prospective, single-blinded, randomized study.


OBJECTIVE
To evaluate the efficacy of dilute betadine irrigation of spinal surgical wounds in prevention of postoperative wound infection.


BACKGROUND
Deep wound infection is a serious complication of spinal surgery that can jeopardize patient outcomes and increase costs. Povidoneiodine is a widely used antiseptic with bactericidal activity against a wide spectrum of pathogens, including methicillin-resistant Staphylococcus aureus. The aim of this study was to evaluate the efficacy of dilute betadine solution in the prevention of wound infection after spinal surgery.


METHODS
Four hundred and fourteen patients undergoing spinal surgery were randomly assigned to two groups. In group 1 (208 patients), surgical wounds were irrigated with dilute betadine solution (3.5% betadine) before wound closure. Betadine irrigation was not used in group 2 (206 patients). Otherwise, perioperative management was the same for both groups.


RESULTS
Mean length of follow-up was 15.5 months in both groups (range, 6-24 months). No wound infection occurred in group 1. One superficial infection (0.5%) and six deep infections (2.9%) occurred in group 2. The differences between the deep infection rate (P = 0.0146) and total infection rate (P = 0.0072) were significant between the two groups.


CONCLUSIONS
Our report is the first prospective, single-blinded, randomized study to evaluate the clinical effectiveness of dilute betadine solution irrigation for prevention of wound infection following spinal surgery. We recommended this simple and inexpensive measure following spinal surgery, particularly in patients with accidental wound contamination, risk factors for wound infection, or undergoing surgery in the absence of routine ultraviolet light, laminar flow, and isolation suits.
Cheng
Ming-Te
MT
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taiwan.
Chang
Ming-Chau
MC
Wang
Shih-Tien
ST
Yu
Wing-Kwang
WK
Liu
Chien-Lin
CL
Chen
Tain-Hsiung
TH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019999:Pharmaceutical Solutions / Q000008:administration & dosage; D011182:Postoperative Care / Q000379:methods; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011446:Prospective Studies; D011512:Proteus Infections / Q000188:drug therapy / Q000517:prevention & control*; D016037:Single-Blind Method; D013116:Spinal Cord / Q000187:drug effects / Q000382:microbiology / Q000601:surgery*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000517:prevention & control*; D007507:Therapeutic Irrigation / Q000379:methods
D019999:Pharmaceutical Solutions; D011206:Povidone-Iodine