Comparison of the efficacy of chlorhexidine gluconate versus povidone iodine as preoperative skin preparation for the prevention of surgical site infections in clean-contaminated upper abdominal surgeries.
OBJECTIVE
To compare the efficacy of chlorhexidine-gluconate versus povidone iodine in preoperative skin preparation in the prevention of surgical site infections (SSIs) in clean-contaminated upper abdominal surgeries.


METHODS
This was a prospective randomized controlled trial conducted on patients undergoing clean-contaminated upper abdominal surgeries. A total of 351 patients 18-70 years old were randomized into two groups; chlorhexidine and povidone iodine skin preparation before surgery.


RESULTS
The incidence of SSIs in the chlorhexidine group was 10.8 %, in comparison to 17.9 % in the povidone iodine group. The odds ratio was 0.6 in favor of chlorhexidine use, but the results were not statistically significant (P = 0.06). In the first postoperative week, SSIs developed in 7 % of patients in the chlorhexidine group and 14.1 % in the povidone iodine group (P = 0.03), and in the second postoperative week, SSIs were present in 4.1 % of the patients in the chlorhexidine group and 4.4 % in the povidone iodine group, which was not statistically significant (P = 0.88).


CONCLUSIONS
The incidence of SSIs after clean-contaminated upper abdominal surgeries was lower with the use of chlorhexidine skin preparation than with povidone iodine preparation, although the results were not statistically significant. However, the odds ratio between the two groups favored the use of chlorhexidine over povidone iodine for preventing SSIs.
Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Anirudh
A
Srinivas
Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India. kamanlil@yahoo.com.
Lileswar
L
Kaman
Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Prithivi
P
Raj
Department of Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Vikas
V
Gautam
Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Divya
D
Dahiya
Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Gurpreet
G
Singh
Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Rajinder
R
Singh
Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Bikash
B
Medhi
D000005:Abdomen / Q000601:surgery*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011300:Preoperative Care; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology*; D012996:Solutions; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D012996:Solutions; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
Chlorhexidine; Clean-contaminated surgeries; Povidone iodine; Skin preparation solutions; Surgical site infection