Chlorhexidine and alcohol versus povidone-iodine for antisepsis in gynecological surgery.
نویسندگان
چکیده
BACKGROUND Surgical site infections (SSIs) cause severe morbidity and are associated with tremendous health costs. Skin antisepsis (cleansing) with chlorhexidine and alcohol solutions has demonstrated superiority to povidone-iodine in a variety of surgical interventions. Our objective was to determine if chlorhexidine and alcohol antisepsis protocol reduces the rate of SSIs in elective gynecological laparotomies compared with povidone-iodine antisepsis. METHODS This retrospective study was carried out at the Department of Gynecology in a tertiary medical center in Tel Aviv. Patients undergoing elective gynecological laparotomies during two periods of time and 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 = 145) and chlorhexidine 2% followed by 70% alcohol (n = 111). The rate of SSIs as defined by the Centers for Disease Control and Prevention (CDC), and the risk factors for the occurrence of SSIs were calculated. RESULTS Antisepsis with chlorhexidine and alcohol was associated with a reduction in the overall rate of SSIs from 14.6% to 4.5% compared with the povidone-iodine protocol (p = 0.011). The two groups of patients were similar in regard to baseline characteristics and medical history. Surgical procedures as well as the type of cut, drains, and tension suture use were similar in the two groups. Patients with SSIs tended to be older and heavier. Risk factors found to be associated with SSIs were hypertension, noninsulin-dependent diabetes mellitus (NIDDM), immunodeficiency, and the use of the povidone-iodine antisepsis protocol. CONCLUSIONS This retrospective study demonstrates that antisepsis with chlorhexidine and alcohol was associated with a significant reduction in the rate of SSIs compared to povidone-iodine antisepsis in patients undergoing elective gynecological laparotomies. This is of extreme clinical importance, as a change in antisepsis protocol can significantly reduce the morbidity and healthcare costs associated with patients undergoing elective gynecological surgery.
منابع مشابه
Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis.
BACKGROUND Since the patient's skin is a major source of pathogens that cause surgical-site infection, optimization of preoperative skin antisepsis may decrease postoperative infections. We hypothesized that preoperative skin cleansing with chlorhexidine-alcohol is more protective against infection than is povidone-iodine. METHODS We randomly assigned adults undergoing clean-contaminated surg...
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Introduction Catheter-related infections are common life-threatening healthcare-associated infections whose incidence can be decreased by improving the quality of care. Optimisation of skin antisepsis is essential to prevent short-term catheter-related infections. We hypothesised that chlorhexidine-alcohol was more effective than povidone iodine-alcohol as a skin antiseptic for preventing infec...
متن کاملSystematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery.
BACKGROUND Surgical-site infection increases morbidity, mortality and financial burden. The preferred topical antiseptic agent (chlorhexidine or povidone-iodine) for preoperative skin cleansing is unclear. METHODS A meta-analysis of clinical trials was conducted to determine whether preoperative antisepsis with chlorhexidine or povidone-iodine reduced surgical-site infection in clean-contamin...
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Background and Aim: Preparing the skin for surgery with antiseptics is a standard measure to reduce surgical site infection. This study aimed to evaluate the effect of skin preparation at the surgical site with povidone-iodine 7.5% and povidone-iodine 10% antiseptics with chlorhexidine and povidone-iodine 10% on the microbial count. Methods: This clinical trial study was performed on 80 patient...
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Skin antisepsis prior to the induction of spinal anesthesia is essential because of the potential for infectious complications. Povidone-iodine is a widely used antiseptic solution for skin preparation before spinal anesthesia, and chlorhexidine alcohol solution is a commonly used alternative to povidone-iodine. Previous studies have shown that chlorhexidine is more effective than povidone-iodi...
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ورودعنوان ژورنال:
- Journal of women's health
دوره 20 3 شماره
صفحات -
تاریخ انتشار 2011