Chlorhexidine gluconate versus povidone iodine at cesarean delivery: a randomized controlled trial.
OBJECTIVE
To compare the prevalence of positive bacterial cultures at the cesarean delivery (CD) incision site in patients with pre-operative application of chlorhexidine gluconate (CG) versus povidone iodine (PI).


METHODS
Women undergoing a scheduled CD at ≥36 gestational weeks were randomly assigned to receive CG or PI. A swab of the incision site was performed at 3 min after disinfectant application and at 18 post-operative hours, and the prevalence of cultures with any detected bacterial growth was compared for the two groups.


RESULTS
Of the 60 participants, 33 (55.0%) were in the PI group. There were no differences detected at 3 min, with 9.1% positive in the PI group versus 0% positive in the CG group (p = 0.2499). However, at 18 h, women in the PI group were seven times more likely than women in the CG group to have a positive culture (16/33 [48.5%] versus 3/27 [11.1%], OR = 7.53 [95% CI 1.67-38.83], p = 0.0023). Multivariate logistic regression demonstrated similar results: OR = 7.33 (95% CI 1.77-30.35), p = 0.0060.


CONCLUSIONS
The prevalence of positive bacterial cultures obtained at the site of the skin incision 18 h after CD was higher in the PI versus the CG group.
Department of Obstetrics and Gynecology, University of Southern California Medical Center , Los Angeles, CA , USA.
Cynelle M
CM
Kunkle
Jennifer
J
Marchan
Sara
S
Safadi
Stephanie
S
Whitman
Ramen H
RH
Chmait
D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D011206:Povidone-Iodine / Q000627:therapeutic use*; D011247:Pregnancy; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
Cesarean delivery; chlorhexidine; iodine; skin disinfectant