Abstract
ObjectivesTo compare the efficacy of chlorhexidine–alcohol and povidone–iodine as preoperative antiseptic skin preparation for prevention of surgical site infection (SSI) after cesarean delivery (CD).Materials and methodsA total of 311 eligible women who underwent CS were recruited in the study after fulfilling all the eligibility and exclusion criteria. Patients were randomized into two groups (153 in chlorhexidine–alcohol group and 158 in povidone–iodine group) by a computer-generated randomization table. Patients were followed for a period of 30 days in postoperative period to monitor for SSI.ResultsThe rate of SSI in the chlorhexidine–alcohol group is 5.4% and that of the povidone–iodine group is 8.6%. E. coli, K. pneumoniae, and Acinetobacter baumannii were the most common organisms isolated. E. coli was found in 9.5% of the total SSI cases.ConclusionsThe study found that the patients who received chlorhexidine–alcohol as skin antiseptic had less chance of developing SSI than those who received povidone–iodine; however, it did not reach a statistical significance.Trial registrationClinical Trials Registry of India CTRI/2018/05/014294. Registered on May 31, 2018
Highlights
E. coli was found in 9.5% of the total Surgical site infection (SSI) cases
The study found that the patients who received chlorhexidine–alcohol as skin antiseptic had less chance of developing SSI than those who received povidone–iodine; it did not reach a statistical significance
Surgical site infection (SSI) is the second most common cause of nosocomial infections among the hospitalized patients covering about 14–16% of all nosocomial infections [1]
Summary
Surgical site infection (SSI) is the second most common cause of nosocomial infections among the hospitalized patients covering about 14–16% of all nosocomial infections [1]. Post-cesarean complications due to infection have been estimated to occur in 7–20% of patients [2]. The rate of infection varies widely according to patient profile depending on several risk factors such as low socioeconomic status, maternal medical disorders, immunosuppression, steroid use, blood. There are many extrinsic factors attributing to SSI which include patient’s skin preparation, hand scrubbing techniques, environment of the operating room, processing of instruments, and hospital items which are to be used in the operating room [9]. Contamination of the surgical site by endogenous skin commensals or vaginal flora is a fundamental precursor to post-operative SSI after CD. Infections are more of mixed polymicrobial which may include enterococci, gram-negative bacilli, group B streptococci, and anaerobes [10, 11]
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