What is the best skin prep to prevent C-section wound infections?
Based on a randomized controlled trial (RCT),
Using chlorhexidine based antiseptic results in significantly less post-surgical site infections following cesarean section compared to iodine based antiseptic.
Tuuli and colleagues (NEJM, 2016) report results of a single site RCT, designed to determine which skin prep agent prevents more surgical site infections following cesarean section. The primary outcome was both superficial and deep infections within a month after the surgery, using Centers for Disease Control and Prevention (CDC) definitions.
Cesarean sections are the most common major surgery performed in women in the United States
Chlorhexidine outperformed Iodine preparation, 4% to 7.3%
Results are consistent with other studies comparing these antiseptics
Chlorhexadine is active against many gram positive and negative bacteria
Consider potential allergic reactions, and moderately higher costs
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