Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery

Br J Surg. 2010 Nov;97(11):1614-20. doi: 10.1002/bjs.7214.

Abstract

Background: Surgical-site infection increases morbidity, mortality and financial burden. The preferred topical antiseptic agent (chlorhexidine or povidone-iodine) for preoperative skin cleansing is unclear.

Methods: A meta-analysis of clinical trials was conducted to determine whether preoperative antisepsis with chlorhexidine or povidone-iodine reduced surgical-site infection in clean-contaminated surgery.

Results: The systematic review identified six eligible studies, containing 5031 patients. Chlorhexidine reduced postoperative surgical-site infection compared with povidone-iodine (pooled odds ratio 0.68, 95 per cent confidence interval 0.50 to 0.94; P = 0.019) .

Conclusion: Chlorhexidine should be used preferentially for preoperative antisepsis in clean-contaminated surgery.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Anti-Infective Agents, Local / therapeutic use*
  • Chlorhexidine / therapeutic use*
  • Humans
  • Middle Aged
  • Povidone-Iodine / therapeutic use*
  • Surgical Wound Infection / prevention & control*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Povidone-Iodine
  • Chlorhexidine