SKIN PREPARATION FROM CHLORHEXIDINE SCRUB VERSUS POVIDONE-IODINE IN THE PREVENTION OF SURGICAL SITE INFECTION AFTER GYNECOLOGICAL SURGERY
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Keywords
Chlorhexidine; Povidone-Iodine; Surgical Site Infection; Gynecologic Surgical Procedures; Randomized Controlled Trial.
Abstract
Background: Surgical site infection (SSI) is the leading preventable complication of gynecologic surgery. We aimed to determine whether adding a 2 % chlorhexidine scrub to standard 10 % povidone-iodine painting lowers 30-day SSI after gynecologic operations.
Methodology: In a single-center, parallel-group randomized controlled trial, 408 women aged 18–45 years scheduled for elective or emergency gynecologic surgery at Liaquat National Hospital, Karachi, were randomly assigned (1:1) to pre-incision skin preparation with either 2 % chlorhexidine scrub plus 10 % povidone-iodine (Group A) or 10 % povidone-iodine alone (Group B). All participants received 1 g intravenous ceftriaxone 30 minutes before incision. Patients were reviewed daily until postoperative day 5 and weekly until day. Data were analyzed using IBM SPSS version 25.
Results: Baseline demographics and comorbidities were well balanced. SSI developed in 10/204 women (4.9 %) in Group A versus 23/204 (11.3 %) in Group B, corresponding to a 57 % relative risk reduction (p = 0.018). Superficial infections predominated while deep/organ-space events were uncommon (p = 0.582). Median time to SSI was similar (p = 0.442), and re-operation rates were low. Subgroup analyses showed consistently lower infection rates with the combined regimen.
Conclusion: Incorporating a brief chlorhexidine scrub before povidone-iodine painting halves 30-day SSI after gynecologic surgery, offering a simple, cost-effective enhancement to routine preoperative care.
References
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Dr Nudrat Nazir
Resident, Department of Gynecology And Obstetrics, MBBS, Liaquat National Hospital and Medical College Karachi, Pakistan
Dr Tanweer Ahmed
Assistant Professor of Urology, Baqai Medical University Karachi, MBBS, FCPS, Certificate In Health Professions Education CHPE
Dr Uzma Shabab
FCPS, Diploma In Infertility From Germany, DMAS (DUBAI), Certificate In Health Professions Education (CHPE), Assistant Professor Department of Gynaecology & Obstetrics, Liaquat National Hospital & Medical College Karachi, Pakistan
Dr Karam Un Nisa
Senior Registrar Department of Gynaecology & Obstetrics, MBBS, FCPS, Liaquat National Hospital & Medical College Karachi, Pakistan
Dr Hafiza Maryam Ishaque
Senior Registrar Department of Gynaecology & Obstetrics, MBBS, FCPS, Liaquat National Hospital & Medical College Karachi, Pakistan
Dr Khadija Soomro
Resident, Obstetrics and Gynecology, DOW University Hospital Karachi MBBS Karachi