Meta-analysis of intraoperative povidone-iodine application to prevent surgical-site infection.
BACKGROUND
The effectiveness of intraoperative povidone-iodine (PVI) application in the reduction of surgical-site infection (SSI) remains controversial. This meta-analysis was performed to assess the effect of intraoperative PVI application compared with no antiseptic solution (saline or nothing) on the SSI rate.


METHODS
The meta-analysis included randomized controlled trials that compared intraoperative PVI lavage with no PVI in patients undergoing surgery with SSI as the primary outcome. A fixed-effects or random-effects model was used as appropriate, and heterogeneity was assessed by the Cochran Q and the I(2) value.


RESULTS
Twenty-four randomized controlled trials totalling 5004 patients (2465 patients with PVI and 2539 patients without) were included: 15 in the main analysis and nine in the sensitivity analysis. The rate of SSI was 8.0 per cent in the PVI group and 13.4 per cent in the control group. Intraoperative PVI application significantly decreased the SSI rate (relative risk 0.58, 95 per cent confidence interval 0.40 to 0.83; P = 0.003) and consistent results were observed in subgroup analyses according to the method of PVI administration, its timing and the type of surgery.


CONCLUSIONS
The meta-analysis results suggested that the use of intraoperative PVI reduced rates of SSI.
Fournel
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Hospital Hygiene and Epidemiology Unit, Hôpital du Bocage, BP 77908, 21079 Dijon Cedex, France. isabellefournel@yahoo.fr
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D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D011206:Povidone-Iodine / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine