BACKGROUND: The effectiveness of intraoperative povidone-iodine (PVI) application in the reduction of surgical-site infection (SSI) remains controversial. This meta-analysis was performed to assess the effect of intraoperative PVI application compared with no antiseptic solution (saline or nothing) on the SSI rate. METHODS: The meta-analysis included randomized controlled trials that compared intraoperative PVI lavage with no PVI in patients undergoing surgery with SSI as the primary outcome. A fixed-effects or random-effects model was used as appropriate, and heterogeneity was assessed by the Cochran Q and the I(2) value. RESULTS: Twenty-four randomized controlled trials totalling 5004 patients (2465 patients with PVI and 2539 patients without) were included: 15 in the main analysis and nine in the sensitivity analysis. The rate of SSI was 8.0 per cent in the PVI group and 13.4 per cent in the control group. Intraoperative PVI application significantly decreased the SSI rate (relative risk 0.58, 95 per cent confidence interval 0.40 to 0.83; P = 0.003) and consistent results were observed in subgroup analyses according to the method of PVI administration, its timing and the type of surgery. CONCLUSION: The meta-analysis results suggested that the use of intraoperative PVI reduced rates of SSI.
BACKGROUND: The effectiveness of intraoperative povidone-iodine (PVI) application in the reduction of surgical-site infection (SSI) remains controversial. This meta-analysis was performed to assess the effect of intraoperative PVI application compared with no antiseptic solution (saline or nothing) on the SSI rate. METHODS: The meta-analysis included randomized controlled trials that compared intraoperative PVI lavage with no PVI in patients undergoing surgery with SSI as the primary outcome. A fixed-effects or random-effects model was used as appropriate, and heterogeneity was assessed by the Cochran Q and the I(2) value. RESULTS: Twenty-four randomized controlled trials totalling 5004 patients (2465 patients with PVI and 2539 patients without) were included: 15 in the main analysis and nine in the sensitivity analysis. The rate of SSI was 8.0 per cent in the PVI group and 13.4 per cent in the control group. Intraoperative PVI application significantly decreased the SSI rate (relative risk 0.58, 95 per cent confidence interval 0.40 to 0.83; P = 0.003) and consistent results were observed in subgroup analyses according to the method of PVI administration, its timing and the type of surgery. CONCLUSION: The meta-analysis results suggested that the use of intraoperative PVI reduced rates of SSI.
Authors: Gill Norman; Ross A Atkinson; Tanya A Smith; Ceri Rowlands; Amber D Rithalia; Emma J Crosbie; Jo C Dumville Journal: Cochrane Database Syst Rev Date: 2017-10-30
Authors: Mehrdad Nikfarjam; Laurence Weinberg; Michael A Fink; Vijayaragavan Muralidharan; Graham Starkey; Robert Jones; Kevin Staveley-O'Carroll; Christopher Christophi Journal: World J Surg Date: 2014-02 Impact factor: 3.352
Authors: Tara C Mueller; Martin Loos; Bernhard Haller; André L Mihaljevic; Ulrich Nitsche; Dirk Wilhelm; Helmut Friess; Jörg Kleeff; Franz G Bader Journal: Langenbecks Arch Surg Date: 2015-02-14 Impact factor: 3.445
Authors: Christian Willy; Catharina Scheuermann-Poley; Marcus Stichling; Thomas von Stein; Axel Kramer Journal: Unfallchirurg Date: 2017-07 Impact factor: 1.000
Authors: Deverick J Anderson; Kelly Podgorny; Sandra I Berríos-Torres; Dale W Bratzler; E Patchen Dellinger; Linda Greene; Ann-Christine Nyquist; Lisa Saiman; Deborah S Yokoe; Lisa L Maragakis; Keith S Kaye Journal: Infect Control Hosp Epidemiol Date: 2014-06 Impact factor: 3.254