Chlorhexidine or Iodine Based Skin Prep for Cesarean Sections?
BACKGROUND AND PURPOSE:
Chlorhexidine–alcohol and povidone–iodine solutions are most commonly used for skin prep to pevent surgical site infections following cesarean section
No clear recommendation regarding use of one over the other
ACOG states (see ‘Related ObG Topics’ below) that “Chlorhexidine–alcohol is an appropriate choice” and that while iodophors also have broad spectrum coverage, they tend to be aqueous and not alcohol based
Tolcher et al. (American Journal of Perinatology, 2019) compared chlorhexidine-alcohol with povidone-iodine solutions for skin antisepsis prior to cesarean delivery
Systematic review and meta-analysis
Database search of RCTs
Endometritis excluded (ascending infection, not skin microbes)
Skin prep performed with either
Primary outcome: Surgical site infection (CDC definitions)
Superficial: Skin and subcutaneous tissue of the incision
Deep wound infection: deep soft tissue layers of the incision (e.g., fascial and muscle layers)
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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