title: Preoperative vaginal preparation with baby shampoo compared with povidone-iodine before gynecologic procedures.
abstract: OBJECTIVE
  The objective of this study was to compare the postoperative infection rates between patients receiving either povidone-iodine (PI) or baby shampoo vaginal preparations before gynecologic surgery.
  
  
  METHODS
  Cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  University referral center for gynecologic endoscopy.
  
  
  METHODS
  All patients underwent minimally invasive gynecologic surgery including hysteroscopy or laparoscopy.
  
  
  METHODS
  The agents used for vaginal preparation were either baby shampoo in a 1:1 dilution with sterile normal saline solution or PI 7.5% scrub solution.
  
  
  RESULTS
  Charts were reviewed for evidence of infection within 30 days of surgery (symptoms of urinary tract infection, abdominal or vaginal wound infections, temperature > 100.4 degrees F, and fungal or bacterial vaginitis). A total of 249 cases were collected; 96 subjects underwent surgery before the change to baby shampoo and 153 subjects after. Both groups were well matched for the types of surgery performed, age, risk factors for postoperative infections, and the postoperative diagnosis. The infection rates were 14/96 (14.6%) with PI preparation versus 18/153 (11.8%) with baby shampoo (p = .52).
  
  
  CONCLUSIONS
  Baby shampoo should be studied as an alternative to PI because it is a nonirritating, inexpensive mild detergent. This preliminary study suggests that baby shampoo is as effective as PI in preventing postoperative infection.
authors.affiliation: Center for Special Minimally Invasive Surgery, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Lewis
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Lathi
authors.forename: Patrice
authors.initials: P
authors.lastname: Crochet
authors.forename: Camran
authors.initials: C
authors.lastname: Nezhat
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D015331:Cohort Studies; D003902:Detergents / Q000627:therapeutic use*; D004203:Disinfection / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D011206:Povidone-Iodine / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014621:Vagina / Q000187:drug effects* / Q000382:microbiology
chemical_list: D000891:Anti-Infective Agents, Local; D003902:Detergents; D011206:Povidone-Iodine