SP1.8 Comparing the efficacy of povidone-iodine versus normal saline in laparotomy wound irrigation to prevent surgical site infections: A meta-analysis

Abstract

Abstract Objective Surgical site infections (SSIs) are associated with increased mortality, morbidity and cost to provide healthcare in patients undergoing laparotomy and abdominal surgery. The objective of this study is to evaluate the role of laparotomy wound irrigation either by povidone-iodine (PVI) or normal saline (NS) in patients undergoing laparotomy for various gastrointestinal operations and assess their role to reduce SSIs. Materials and methods Randomized controlled trials (RCTs) reporting the role of laparotomy wound irrigation with PVI versus NS in patients undergoing laparotomy for various gastrointestinal operations and assess their role to reduce the risk of SSIs were retrieved from the search of standard medical electronic databases and analysis was conducted by using the principles of meta-analysis on the statistical software RevMan version 5. Results The search of medical databases yielded 13 RCTs on 3816 patients undergoing laparotomy for various gastrointestinal operations. There were 1900 patients in the PVI group whereas 1916 patients received NS wound irrigations prior to the laparotomy skin wound closure. In the random effects model analysis, the use of PVI for laparotomy wound irrigation was associated with the reduced risk [odds ratio 0.54, 95%, CI (0.30, 0.98), Z = 2.04, P=0.04] of SSIs. However, there was significant heterogeneity (Tau2 = 70; Chi2 = 40.19, df = 12; (P = 0.0001; I2 = 70 %) among included studies. Conclusion Laparotomy wound irrigation with PVI has shown clinically proven advantage of reducing the risk of SSIs.