A STUDY OF COMPARATIVE EVALUATION OF PREOPERATIVE SKIN PREPARATION WITH CHLORHEXIDINE-ALCOHOL VERSUS POVIDONE-IODINE IN PREVENTION OF SURGICAL SITE INFECTIONS

Abstract

Geetha Danasekaran1, Saravanan Rasu2, Manivannan Palani3

BACKGROUND
Surgical site infections is a dangerous condition posing a heavy burden on the patient and social health system. The use of preoperative skin preparation by effective antiseptic plays an important role in reducing postoperative wound infections. Hence, the present study was undertaken to compare and evaluate the efficacy of 2% chlorhexidine-alcohol versus 5% povidone-iodine in abdominal surgeries for prevention of SSI.
MATERIALS AND METHODS
The present one year randomised controlled trial was conducted in the Department of General Surgery, Government Rajaji Hospital, Madurai, over a period from 2014 to 2015 on 120 patients undergoing elective abdominal surgeries. The patients were divided into two groups by computer randomisation that is Group A (chlorhexidine-alcohol group) and Group B (povidone-iodine group). The surgical wounds were examined for any infections present.
RESULTS
Most of the patients were males in both the groups (73.33% and 61.67% in group A and B, respectively). Half of the patients (50%) in both the groups had chronic appendicitis. The mean duration of surgery in group A was 44.66 ± 5.86 minutes, and in group B, it was 45.00 ± 6.24 minutes. Staphylococcus aureus (1.67% in group A and 10% in group B) was the most common organism isolated after skin preparation. After the application of antiseptic agents, there was reduction of bacterial colonisation in both the groups, but significant reduction was seen in chlorhexidine group. In group A, two patients had superficial SSIs compared to 14 patients in group B (p=0.001). The mean length of hospital stay in group A was significantly less (7.20 ± 1.10 vs. 8.67 ± 3.17).
CONCLUSION
Preoperative skin cleansing with chlorhexidine significantly reduces risk of postoperative SSIs and colonisation of bacteria in clean abdominal surgeries.

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