N Engl J Med. Author information: 1 Michael E. Evid Based Nurs. J Am Coll Surg. Spine Phila Pa We hypothesized that preoperative skin cleansing with chlorhexidine-alcohol is more protective against infection than is povidone-iodine.
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Am J Obstet Gynecol. Epub Jun 7. Electronic address: Edward. Springel vcuhealth. Two recently published investigations examined efficacy of chlorhexidine-alcohol and iodine-alcohol preparations. No previous randomized controlled trial has compared chlorhexidine-alcohol to povidone-iodine aqueous scrub and paint in reduction of cesarean-related surgical site infection. OBJECTIVE: The purpose of the study was to determine if chlorhexidine-alcohol would result in fewer surgical site infections than povidone-iodine when used as skin antisepsis preparation prior to cesarean delivery.
STUDY DESIGN: This study was a single-center pragmatic randomized controlled trial at an urban tertiary care institution to compare chlorhexidine-alcohol mL single-step applicator to povidone-iodine aqueous scrub and paint mL wet skin tray as preoperative skin antiseptic preparation for women undergoing cesarean delivery. Treatment was assigned by computer-generated simple randomization immediately before skin preparation. Analysis was by intent to treat.
Categorical outcomes were compared using Fisher exact test. The Wilcoxon rank-sum test was performed for continuous outcomes. This trial was institutional review board approved and registered at ClinicalTrials. Surgical site infection occurred in 29 6. The rates of individual components of the primary outcome were as follows: superficial surgical site infection 4. All results were similar in per protocol analysis. CONCLUSION: Preoperative antiseptic skin preparation with chlorhexidine-alcohol mL single-step applicator before cesarean did not result in less frequent surgical site infection when compared with povidone-iodine aqueous scrub and paint mL wet skin preparation tray.
Povidone-iodine should still be considered as acceptable for preoperative surgical site antisepsis for cesarean delivery. All rights reserved.
Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis.
Received Nov 9; Accepted Jan Pre-surgical asepsis of the skin is one of the preventive measures performed to reduce SSI incidence and also antibiotic resistance dissemination. However, in veterinary medicine there is no agreement on which biocide is the most effective. The aim of this study was to evaluate the effectiveness of two pre-surgical skin asepsis protocols in dogs. A total of 46 animals were randomly assigned for an asepsis protocol with an aqueous solution of 7. For each dog, two skin swab samples were collected at pre-asepsis and post-asepsis, for bacterial quantification by conventional techniques and isolation of methicillin-resistant species. Also, the logarithmic reduction of the bacterial quantification from pre- and post-asepsis time, was not statistically different for povidone-iodine 6.