title: Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery.
abstract: BACKGROUND
  Surgical-site infection increases morbidity, mortality and financial burden. The preferred topical antiseptic agent (chlorhexidine or povidone-iodine) for preoperative skin cleansing is unclear.
  
  
  METHODS
  A meta-analysis of clinical trials was conducted to determine whether preoperative antisepsis with chlorhexidine or povidone-iodine reduced surgical-site infection in clean-contaminated surgery.
  
  
  RESULTS
  The systematic review identified six eligible studies, containing 5031 patients. Chlorhexidine reduced postoperative surgical-site infection compared with povidone-iodine (pooled odds ratio 0.68, 95 per cent confidence interval 0.50 to 0.94; P = 0.019) .
  
  
  CONCLUSIONS
  Chlorhexidine should be used preferentially for preoperative antisepsis in clean-contaminated surgery.
authors.affiliation: Department of Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: A
authors.initials: A
authors.lastname: Noorani
authors.forename: N
authors.initials: N
authors.lastname: Rabey
authors.forename: S R
authors.initials: SR
authors.lastname: Walsh
authors.forename: R J
authors.initials: RJ
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D011206:Povidone-Iodine / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D002710:Chlorhexidine