Pre-Operative Skin Antisepsis with Chlorhexidine Gluconate and Povidone-Iodine to Prevent Port-Site Infection in Laparoscopic Cholecystectomy: A Prospective Study

Surg Infect (Larchmt). 2018 Apr;19(3):334-338. doi: 10.1089/sur.2017.269. Epub 2018 Feb 9.


Background: Skin preparation with antiseptic agents is commonly recommended for incisional site cleansing before surgery. We present the result of a prospective case series submitted to a scheduled pre-operative antiseptic procedure combining chlorhexidine gluconate and povidone-iodine before elective laparoscopic cholecystectomy.

Patients and methods: Consecutive patients underwent pre-operative standardized cleansing of the operation site combining chlorhexidine gluconate and povidone-iodine. Patients were reviewed one week and four weeks post-operatively.

Results: Post-operative infection was observed in seven patients (4.3%). All observed infections were port-site infections, always located at the level of the umbilical incision. In all cases infections involved skin and subcutaneous tissue. Staphylococcus aureus was isolated in five patients (71.4%) and miscellaneous aerobic gram-positive bacteria in two subjects (28.6%). Post-operative hospital stay was the only factor significantly associated with the development of port-site infections.

Conclusions: Port-site infections are a common complication after elective laparoscopic cholecystectomy. The proposed pre-operative disinfection procedure is effective in reducing port-site infections. Reducing hospital stay may contribute to limiting the occurrence of this complication.

Keywords: incision infection; laparoscopic cholecystectomy; pre-operative antisepsis.

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use*
  • Antibiotic Prophylaxis / methods
  • Antibiotic Prophylaxis / statistics & numerical data
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use
  • Cholecystectomy, Laparoscopic* / adverse effects
  • Cholecystectomy, Laparoscopic* / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Povidone-Iodine / therapeutic use*
  • Preoperative Care* / methods
  • Preoperative Care* / statistics & numerical data
  • Prospective Studies
  • Surgical Wound Infection* / drug therapy
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / prevention & control


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