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#Grand Rounds

Chlorhexidine or Povidone-Iodine for abdominal hysterectomy?

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BACKGROUND AND PURPOSE: 

 

  • Uppal et. al. (Obstetrics and Gynecology, 2017) compared preoperative chlorhexidine-alcohol with povidone-iodine for benign abdominal hysterectomy 

METHODS: 

  • Retrospective Cohort Study (2012-2015) 
  • Multivariable logistic regression and propensity score (to address indication bias) to test associations 
  • Primary outcome  
    • Surgical site infection within 30 days 

RESULTS:

  • 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%) 

CONCLUSION: 

  • Use of chlorhexidine-alcohol skin prep has 44% lower odds of resulting in a surgical site infection compared with povidone-iodine 

Learn More – Primary Sources:

Chlorhexidine-Alcohol Compared With Povidone-Iodine for Preoperative Topical Antisepsis for Abdominal Hysterectomy

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