Chlorhexidine-alcohol versus povidone-iodine as preoperative skin preparation to prevent surgical site infection: a meta-analysis
Abstract: Surgical site
infection remains substantial problems to surgeons and patients as it increases
the morbidity, mortality, length of stay, hospital cost, rate of re-admission,
and rate of re-surgery. This study aims to compare the use of
chlorhexidine-alcohol versus povidone-iodine for preoperative skin preparation
to prevent surgical site infection.
Methods: The literature search was conducted through the PubMed database
on November 2015. Included studies were RCTs with the year of publication up to
2015 which compared the use of chlorhexidine-alcohol versus povidone-iodine in
its effectiveness reducing surgical site infection in adult patients. The
quality of the study was assessed using Jadad Score. A meta-analysis was
conducted in the included study to obtain a pooled estimate of the effect size.
The evidence of heterogeneity and publication bias was also assessed.
Results: Six RCTs with a total of 2,080 patients were included in the
meta-analysis. It showed that the use of chlorhexidine-alcohol was associated
significantly with fewer SSIs (pooled risk ratio=0.60 (95% CI=0.45-0.79)) and
fewer positive skin culture results (pooled risk ratio, RR=0.38 (95%
CI=0.28-0.51)) compared with povidone iodine.
Conclusion: Preoperative skin antisepsis with chlorhexidine is more
effective than povidone-iodine in preventing surgical site infection.
Keywords: chlorhexidine-alcohol;
povidone-iodine; skin antisepsis; surgical site infection
Author: Tasya Anggrahita,
Aditya Wardhana, Gentur Sudjatmiko
Journal Code: jpkedokterangg170183
