Shi Chen1, Jun Wu Chen2, Bin Guo2, Chun Cheng Xu2. 1. Department of Orthopedics, Ninghai Medical Center First Hospital, 142 Taoyuan Road, Ninghai County, Ningbo City, 315600, Zhejiang Province, China. chenshi65536811@126.com. 2. Department of Orthopedics, Ninghai Medical Center First Hospital, 142 Taoyuan Road, Ninghai County, Ningbo City, 315600, Zhejiang Province, China.
Abstract
BACKGROUND AND OBJECTIVE: Chlorhexidine (CH) and povidone-iodine (PI) are the most commonly used preoperative skin antiseptics at present. However, the prevention of the surgical site infection (SSI) and the incidence of skin adverse events do not reach a consistent statement and conclusion. This meta-analysis aimed to evaluate the efficacy of chlorhexidine and povidone-iodine in the prevention of postoperative surgical site infection and the incidence of corresponding skin adverse events. METHOD: Substantial studies related to "skin antiseptic" and "surgical site infection" were consulted on PUBMED, Web of Science, EMBASE, and CNKI. The primary outcome was the incidence of postoperative SSI. The secondary outcome was associated with skin adverse events. All data were analyzed with Revman 5.3 software. RESULTS: A total of 30 studies were included, including 29,006 participants. This study revealed that chlorhexidine was superior to povidone-iodine in the prevention of postoperative SSI (risk ratio [RR], 0.65; 95% confidence interval [CI], 0.55-0.77; p < 0.00001, I2 = 57%). Further subgroup analysis showed that chlorhexidine was superior to povidone-iodine in the prevention of postoperative SSI in clean surgery (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.67-0.98; p = 0.03), I2 = 28%) and clean-contaminated surgery (risk ratio [RR], 0.58; 95% confidence interval [CI], 0.47-0.73; p < 0.00001, I2 = 43%). However, there was no statistically significant difference in the incidence of skin adverse events between CH and PI groups. CONCLUSION: Chlorhexidine was superior to povidone-iodine in preventing postoperative SSI, especially for the clean-contaminated surgery. However, there was no statistically significant difference in the incidence of skin adverse events between CH and PI groups.
BACKGROUND AND OBJECTIVE:Chlorhexidine (CH) and povidone-iodine (PI) are the most commonly used preoperative skin antiseptics at present. However, the prevention of the surgical site infection (SSI) and the incidence of skin adverse events do not reach a consistent statement and conclusion. This meta-analysis aimed to evaluate the efficacy of chlorhexidine and povidone-iodine in the prevention of postoperative surgical site infection and the incidence of corresponding skin adverse events. METHOD: Substantial studies related to "skin antiseptic" and "surgical site infection" were consulted on PUBMED, Web of Science, EMBASE, and CNKI. The primary outcome was the incidence of postoperative SSI. The secondary outcome was associated with skin adverse events. All data were analyzed with Revman 5.3 software. RESULTS: A total of 30 studies were included, including 29,006 participants. This study revealed that chlorhexidine was superior to povidone-iodine in the prevention of postoperative SSI (risk ratio [RR], 0.65; 95% confidence interval [CI], 0.55-0.77; p < 0.00001, I2 = 57%). Further subgroup analysis showed that chlorhexidine was superior to povidone-iodine in the prevention of postoperative SSI in clean surgery (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.67-0.98; p = 0.03), I2 = 28%) and clean-contaminated surgery (risk ratio [RR], 0.58; 95% confidence interval [CI], 0.47-0.73; p < 0.00001, I2 = 43%). However, there was no statistically significant difference in the incidence of skin adverse events between CH and PI groups. CONCLUSION:Chlorhexidine was superior to povidone-iodine in preventing postoperative SSI, especially for the clean-contaminated surgery. However, there was no statistically significant difference in the incidence of skin adverse events between CH and PI groups.
Authors: Edward H Springel; Xiao-Yu Wang; Vanessa M Sarfoh; Bradley P Stetzer; Steven A Weight; Brian M Mercer Journal: Am J Obstet Gynecol Date: 2017-06-07 Impact factor: 8.661
Authors: Margaret M Hannan; Katie E O'Sullivan; Ann M Higgins; Ann-Marie Murphy; James McCarthy; Edmund Ryan; John P Hurley Journal: Surg Infect (Larchmt) Date: 2015-08-10 Impact factor: 2.150
Authors: Brian R Swenson; Traci L Hedrick; Rosemarie Metzger; Hugo Bonatti; Timothy L Pruett; Robert G Sawyer Journal: Infect Control Hosp Epidemiol Date: 2009-10 Impact factor: 3.254
Authors: Ivan M Ngai; Anne Van Arsdale; Shravya Govindappagari; Nancy E Judge; Nicole K Neto; Jeffrey Bernstein; Peter S Bernstein; David J Garry Journal: Obstet Gynecol Date: 2015-12 Impact factor: 7.661
Authors: Ryckie G Wade; Gráinne Bourke; Justin C R Wormald; Joshua Philip Totty; Guy Henry Morton Stanley; Andrew Lewandowski; Sandeep Singh Rakhra; Matthew D Gardiner Journal: BJS Open Date: 2021-11-09