Minimizing wound contamination in a 'clean' surgery: comparison of chlorhexidine-ethanol and povidone-iodine.
OBJECTIVE
There is limited work analyzing the efficacy of different antiseptics in reducing wound contamination by the skin flora during hernia repair and its influence on the incidence of wound infection, which continues to be a major problem in the developing world. This study was designed to test if chlorhexidine-ethanol has superior antimicrobial efficacy compared with povidone-iodine.


METHODS
In a prospective randomized trial, the efficacy of chlorhexidine-ethanol and povidone-iodine in the reduction of colony counts of the skin flora and the incidence of surgical site infection was compared.


RESULTS
Both povidone-iodine and chlorhexidine-ethanol produced significant reduction in the skin bacterial colony counts, from 18.66 x 10(2) to 2.34 x 10(2) colony-forming units with povidone-iodine (59%) and from 12.34 x 10(2) to 0.93 x 10(2) colony-forming units (82%) with chlorhexidine-ethanol. Infection rates with the use of povidone-iodine and chlorhexidine-ethanol groups were not significantly different (9.5 vs. 7.0; p = 0.364). The reduction in colony counts in those who developed infection was only 15.6% compared with 77.1% in those who did not develop infection.


CONCLUSIONS
The antibacterial efficacy of chlorhexidine-ethanol and povidone-iodine is comparable in open hernia repair.
Sistla
Sarath Chandra
SC
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. sarathsistla@hotmail.com
Prabhu
Ganesh
G
Sistla
Sujatha
S
Sadasivan
Jagdish
J
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006547:Hernia / Q000150:complications; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000008:administration & dosage / Q000627:therapeutic use*; D012867:Skin / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000891:Anti-Infective Agents, Local; D000431:Ethanol; D011206:Povidone-Iodine; D002710:Chlorhexidine