title: Betadine irrigation and post-craniotomy wound infection.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the efficacy of betadine irrigation in preventing postoperative wound infection in cranial neurosurgical procedures.
  
  
  METHODS
  A total of 473 consecutive cranial neurosurgical procedures, including craniotomies and burr hole procedures were retrospectively reviewed. Patients had either antibiotic irrigation or dilute betadine plus antibiotic irrigation prior to skin closure. Infection was determined by purulence noted on reoperation and confirmed with bacterial growth culture. One and three month postoperative infection rates were calculated. Statistical analysis was performed using Chi-squared tests.
  
  
  RESULTS
  This study included 404 patients. Betadine was used in 117 (29.0%). At 1 month after surgery, there was no difference in the rate of wound infection between the two groups (1.7% each). However, at 90 days, the betadine group had a 2.6% infection rate compared with 3.8% in the antibiotic group, indicating a 33% decrease in infection rates with the addition of betadine (p=.527). The small sample size of the study produced a low power and high beta error.
  
  
  CONCLUSIONS
  In this small preliminary study, betadine decreased postoperative infection rates compared with antibiotic prophylaxis alone at 90 days but not 30 days. This was not statistically significant, but a larger sample size would lower the beta error and decrease confounding bias associated with group heterogeneity. The potential for betadine, a cheap, low toxicity antimicrobial, to decrease infection rates and reoperations for infection warrants a larger multicenter trial.
authors: Department of Neurosurgery, Brain and Spine Center, Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA.
authors: Kunal S
authors: KS
authors: Patel
authors: Department of Neurosurgery, Brain and Spine Center, Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA.
authors: Brandon
authors: B
authors: Goldenberg
authors: Department of Neurosurgery, Brain and Spine Center, Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA; Department of Otolaryngology, Brain and Spine Center, Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA; Department of Neurology and Neuroscience, Brain and Spine Center, Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA. Electronic address: schwarh@med.cornell.edu.
authors: Theodore H
authors: TH
authors: Schwartz
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000601:surgery; D003399:Craniotomy / Q000009:adverse effects*; D016527:Drug Costs; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011206:Povidone-Iodine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000191:economics / Q000382:microbiology / Q000517:prevention & control*; D007507:Therapeutic Irrigation
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine
keywords: Betadine; Craniotomy; Infection; Therapeutic irrigation