title: Can we reduce the surgical site infection rate in cesarean sections using a chlorhexidine-based antisepsis protocol?
abstract: OBJECTIVE
  To determine whether chlorhexidine-based antisepsis reduces the rate of surgical site infections (SSIs) in elective and non-elective cesarean sections (CS) compared with povidone-iodine protocol.
  
  
  METHODS
  This was a retrospective study. Women undergoing elective and non-elective CS during two periods of time who were treated with two different antisepsis protocols were included. The protocols for antisepsis were povidone-iodine 10% scrub followed by 10% povidone-iodine in 65% alcohol (n = 163) and chlorhexidine 2% followed by 70% alcohol (n = 163). The rate of SSIs and the risk factors for their occurrence were calculated and compared between the two groups.
  
  
  RESULTS
  Antisepsis with chlorhexidine and alcohol was associated with a lower rate of SSIs, 10.43% versus 3.07% with povidone-iodine (p = 0.08). The two groups of patients were similar in baseline characteristics. Risk factors associated with SSIs were body mass index, urgent CS, and the use of the povidone-iodine protocol.
  
  
  CONCLUSIONS
  Antisepsis with Chlorhexidine-based regimen was associated with a significant reduction in the rate of SSIs compared to povidone-iodine antisepsis in women undergoing elective and non-elective CS. This is of extreme clinical importance, as a change in antisepsis protocol can significantly reduce the morbidity and healthcare costs regarding cesarean sections.
authors.affiliation: Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel and.
authors.forename: Jonia
authors.initials: J
authors.lastname: Amer-Alshiek
authors.forename: Tahani
authors.initials: T
authors.lastname: Alshiek
authors.forename: Benny
authors.initials: B
authors.lastname: Almog
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Lessing
authors.forename: Abed
authors.initials: A
authors.lastname: Satel
authors.forename: Ariel
authors.initials: A
authors.lastname: Many
authors.forename: Ishai
authors.initials: I
authors.lastname: Levin
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000985:Antisepsis / Q000379:methods*; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data; D002710:Chlorhexidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011206:Povidone-Iodine / Q000627:therapeutic use; D011645:Puerperal Infection / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D002710:Chlorhexidine