Choice of Antiseptic Influences Risk of Surgical Infections

Pavankumar Kamat

September 15, 2020

A study has found that alcoholic chlorhexidine gluconate cuts the risk of infections in certain types of surgery by half compared with the commonly used antiseptic povidone-iodine. The findings were published in  Annals of Surgery .

Researchers at the University of Leeds and the University of Bern conducted a systematic review and meta-analysis of 17 studies which compared infection complications of five antiseptics used in 14,593 surgeries.

The findings showed that alcoholic chlorhexidine gluconate (4%-5%) halved the risk of infections after 'clean' surgeries in adults compared with aqueous (relative risk [RR], 0.49; 95% CI, 0.24-1.02) and alcoholic povidone-iodine (RR, 0.51; 95% CI, 0.21-1.27). Adverse events associated with antiseptic exposure were only observed with the use of povidone-iodine.

'Clean' surgeries refer to procedures performed outside the respiratory, urogenital and digestive system with no inflammation or infection and where the wound is non-traumatic.

Lead author, Ryckie Wade, said: "Even though the risk of infection in these types of surgery is low (about 3%), anything we can change to reduce this risk is very important. This research should be of benefit to all healthcare professionals around the world who perform any type of invasive procedure on a ‘clean site’.”

Wade RG, Burr NE, McCauley G, Bourke G, Efthimiou O. The Comparative Efficacy of Chlorhexidine Gluconate and Povidone-iodine Antiseptics for the Prevention of Infection in Clean Surgery: A Systematic Review and Network Meta-analysis. Ann. Surg.2020 Sep 01 [Epub ahead of print]. doi: 10.1097/SLA.0000000000004076. PMID: 32773627 View abstract

This article originally appeared on Univadis, part of the Medscape Professional Network.


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