Comparison of efficacy of chlorhexidine alcohol scrub and povidone iodine scrub in hand cleansing in elective clean surgery

Authors

  • Yogesh P. Takalkar Department of General Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Mahadeo Namdeo Garale Department of General Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Soundappan Somasundaram Department of General Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Karthik Venkataramani Department of General Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Kalyansing N. Gothwal Department of General Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Saneya A. Pandrowala Department of General Surgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20163180

Keywords:

Surgical site infection, Hand asepsis, Povidone-iodine, Chlorhexidine gluconate

Abstract

Background: Hand asepsis is the best prevention for surgical site infection (SSI). The surgeon uses different methods of surgical hand antisepsis. The present study was undertaken to compare and evaluate the efficacy of chlorhexidine alcohol versus povidone iodine in elective clean surgeries for prevention of SSI.

Methods: We conducted a double blind, prospective, interventional study on patients undergoing elective clean surgeries in general surgical operation theatre of a tertiary care center. Surgeons were assigned randomly to use povidone-iodine 7.5% surgical scrub or chlorhexidine gluconate 2.5% prior to surgery. The number of patients who developed a surgical site infection was expressed as a percentage of the total. Incidence of surgical site infection was calculated individually in both the groups.

Results: Both the groups were comparable in terms of various variables. Infection rates of both the groups were similar with respect to age, gender, duration of surgery, personal history of addictions. However, in case of comparison BMI in both groups in patients who had infection and it was observed that BMI was significantly different in both groups. In normal and overweight patients chlorhexidine group had more infection while moderately obese patient’s povidone-iodine group had more infection.

Conclusions: Povidone-iodine 7.5% surgical scrub and chlorhexidine gluconate both are equally good scrubs in elective clean surgeries. 

References

Bruce J, Russell EM, Mollison J, Krukowski ZH. The measurement and monitoring of surgical/adverse events. Health Technol Assess. 2001;5(22):1-194.

Kurz A, Sessler DI, Lenhardt R. Study of wound infection and temperature group. Perioperative/normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N/Engl J Med. 1996;334(19):1209-15.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Hospital Infection Control Practices/Advisory Committee. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp/Epidemiol. 1999;20(4):250-78.

National Institute for Health and Clinical Excellence (NICE). [Accessed October 1, 2010] Surgical/site infection: draft full guideline. 2006. http://www.nice.org.uk/CG74

Macias JH, Arreguin V, Munoz JM, Alvarez JA, Mosqueda JL, Macias AE. Chlorhexidine is a better antiseptic than povidone iodine and sodium hypochlorite because of its substantive effect. Am J Infect Control. 2013;41(7):634-7.

Brunicardi CF. Surgical Infections. Schwartz’s Principles of Surgery, McGraw Hill Company, 9th International edition, 2010;132-188.

Fleischer W, Reimer K. Povidone-iodine in antisepsis: State of the art. Dermatology. 1997;195:3-9.

Milstone AM, Passaretti CL, Perl TM. Chlorhexidene: Expanding the armamentarium for infection control and prevention. Clin Infect Dis. 2008;46:274-81.

Darouiche RO, Wall MJ, Itani KM, Otterson MF, Webb AL, Carrick MM. Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis. N Engl J Med. 2010 Jan 7;362(1):18-26.

Mimoz O, Karim A, Mercat A, Cosseron M, Falissard B, Parker F. Chlorhexidine compared with povidone-iodine as skin preparation before blood culture. A randomized, controlled trial. Ann Intern Med. 1999;131:834-7.

Adler MT, Brigger KR, Bishop KD, Mastrobattista JM. Comparison of bactericidal properties of alcohol-based chlorhexidine versus povidone-iodine prior to amniocentesis. Am J Perinatol. 2012;29:455-8.

Tschudin-Sutter S, Frei R, Egli-Gany D, Eckstein F, Valderrabano V, Dangel M. No risk of surgical site infections from residual bacteria after disinfection with povidone-iodine-alcohol in 1014 cases: A prospective observational study. Ann Surg. 2012;255:565-9.

Langgartner J, Linde HJ, Lehn N, Reng M, Schölmerich J, Glück T. Combined skin disinfection with chlorhexidine/propanol and aqueous povidone-iodine reduces bacterial colonisation of central venous catheters. Intensive Care Med. 2004;30:1081-8.

Sistla SC, Prabhu G, Sistla S, Sadasivan J. Minimizing wound contamination in a ‘clean’ surgery: Comparison of chlorhexidine-ethanol and povidone-iodine. Chemotherapy. 2010;56:261-7.

Girard R, Comby C, Jacques D. Alcoholic povidone-iodine or chlorhexidine-based antiseptic for the prevention of central venous catheter-related infections: In-use comparison. J Infect Public Health. 2012;5:35-42.

Kinirons B, Mimoz O, Lafendi L, Naas T, Meunier J, Nordmann P. Chlorhexidine versus povidone iodine in preventing colonization of continuous epidural catheters in children: A randomized, controlled trial. Anesthesiology. 2001;94:239-44.

Chaiyakunapruk N, Veenstra DL, Lipsky BA, Saint S. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: A meta-analysis. Ann Intern Med. 2002;136:792–801

Noorani A, Rabey N, Walsh SR, Davies RJ. Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone–iodine in clean-contaminated surgery. British Journal of Surgery. 2010;97(11):1614-20.

Downloads

Published

2016-12-10

Issue

Section

Original Research Articles