Chlorhexidine or Povidone-Iodine for abdominal hysterectomy?
BACKGROUND AND PURPOSE:
Uppal et. al. (Obstetrics and Gynecology, 2017) compared preoperative chlorhexidine-alcohol with povidone-iodine for benign abdominal hysterectomy
Retrospective Cohort Study (2012-2015)
Multivariable logistic regression and propensity score (to address indication bias) to test associations
Surgical site infection within 30 days
4,259 abdominal hysterectomies
Majority of patients had chlorhexidine-alcohol as a skin prep
Overall unadjusted surgical site infection was 29.9%
Comparing chlorhexidine-alcohol to povidone-iodine
Adjusted odds ratio 0.56 (95% CI 0.37–0.85; P=.01)
Had 44% lower odds of developing a surgical site infection
Propensity score matching (one to one), where none of the demographics and risk factors differed significantly between groups, confirmed logistic regression modeling and likewise found a lower percentage of infection in the chlorhexidine-alcohol group compared with povidone-iodine group (1.5% v. 4.7%)
Use of chlorhexidine-alcohol skin prep has 44% lower odds of resulting in a surgical site infection compared with povidone-iodine
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