Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery.
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.
Noorani
A
A
Department of Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Rabey
N
N
Walsh
S R
SR
Davies
R J
RJ
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
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D002710:Chlorhexidine