title: Chlorhexidine with isopropyl alcohol versus iodine povacrylex with isopropyl alcohol and alcohol- versus nonalcohol-based skin preparations: the incidence of and readmissions for surgical site infections after colorectal operations.
abstract: BACKGROUND
  Surgical site infections are a major cause of morbidity and mortality after colorectal operations. Preparation of the surgical site with antiseptic solutions is an essential part of wound infection prevention. To date, there is no universal consensus regarding which preparation is most efficacious.
  
  
  OBJECTIVE
  This study compared 2.0% chlorhexidine with 70.0% isopropyl alcohol versus 0.7% iodine povacrylex with 74.0% isopropyl alcohol and alcohol-based versus nonalcohol-based skin preparations with regard to efficacy in preventing postoperative wound infections.
  
  
  METHODS
  This is a retrospective study from 2 prospectively collected statewide databases combined. A propensity score model was used to adjust for differences between the groups in patient demographics, characteristics, comorbidities, and laboratory values.
  
  
  METHODS
  The multicenter data set used in this analysis represents a variety of academic and community hospitals within the state of Michigan from January 2010 through June 2012.
  
  
  METHODS
  Patients over the age of 18 years who underwent clean-contaminated colorectal operations were included.
  
  
  METHODS
  The incidence of superficial surgical site infections, any surgical site infection, any wound complication, and readmission within 30 days for surgical site infection were measured.
  
  
  RESULTS
  When 2.0% chlorhexidine with 70.0% isopropyl alcohol (n = 425) and 0.7% iodine povacrylex with 74.0% isopropyl alcohol (n = 115) were compared, a total of 540 colorectal cases met inclusion criteria. When alcohol-based (n = 610) and nonalcohol-based (n = 177) skin preparations were compared, a total of 787 colorectal cases met inclusion criteria. There was no significant difference in the propensity-adjusted odds for having any of the 4 outcomes of interest when comparing 2.0% chlorhexidine with 70.0% isopropyl alcohol to 0.7% iodine povacrylex with 74.0% isopropyl alcohol and when comparing alcohol-based with nonalcohol-based skin preparations.
  
  
  CONCLUSIONS
  This was a nonrandomized study performed retrospectively based on data collected within the state of Michigan.
  
  
  CONCLUSIONS
  The use of 2.0% chlorhexidine with 70.0% isopropyl alcohol versus 0.7% iodine povacrylex with 74.0% isopropyl alcohol or alcohol-based versus nonalcohol-based skin preparations does not significantly influence the incidence of surgical site infections or readmission within 30 days for surgical site infection after clean-contaminated colorectal operations.
authors.affiliation: 1 Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, Michigan 2 Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan 3 School of Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Kaoutzanis
authors.forename: Crystal M
authors.initials: CM
authors.lastname: Kavanagh
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Leichtle
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Welch
authors.forename: AkkeNeel
authors.initials: A
authors.lastname: Talsma
authors.forename: James F
authors.initials: JF
authors.lastname: Vandewarker
authors.forename: Richard M
authors.initials: RM
authors.lastname: Lampman
authors.forename: Robert K
authors.initials: RK
authors.lastname: Cleary
mesh_terms: D019840:2-Propanol / Q000008:administration & dosage*; D000180:Acrylic Resins / Q000008:administration & dosage*; D000287:Administration, Topical; D002710:Chlorhexidine / Q000008:administration & dosage*; D003107:Colorectal Surgery / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D007455:Iodine / Q000008:administration & dosage*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000180:Acrylic Resins; D000431:Ethanol; D007455:Iodine; D019840:2-Propanol; D002710:Chlorhexidine