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Chlorhexidine and Alcohol Versus Povidone-Iodine for Antisepsis in Gynecological Surgery.

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Title: Chlorhexidine and Alcohol Versus Povidone-Iodine for Antisepsis in Gynecological Surgery.
Authors: Levin, Ishai (AUTHOR), Amer-Alshiek, Jonia (AUTHOR), Avni, Amiram (AUTHOR), Lessing, Joseph B. (AUTHOR), Satel, Abed (AUTHOR), Almog, Benny (AUTHOR)
Source: Journal of Women's Health (15409996). Mar2011, Vol. 20 Issue 3, p321-324. 4p.
Subjects: Surgical site infections, Surgical site infection prevention, Povidone-iodine, Chlorhexidine, Ethanol, Abdominal surgery, Academic medical centers, Analysis of variance, Bactericides, Chi-squared test, Comparative studies, Confidence intervals, Epidemiology, Fisher exact test, Gynecologic surgery, Health outcome assessment, Regression analysis, T-test (Statistics), Data analysis, Treatment effectiveness, Retrospective studies, Disease risk factors, Therapeutics
Geographic Terms: Israel
Abstract: Background: Surgical site infections (SSIs) cause severe morbidity and are associated with tremendous health costs. Skin antisepsis (cleansing) with chlorhexidine and alcohol solutions has demonstrated superiority to povidone-iodine in a variety of surgical interventions. Our objective was to determine if chlorhexidine and alcohol antisepsis protocol reduces the rate of SSIs in elective gynecological laparotomies compared with povidone-iodine antisepsis. Methods: This retrospective study was carried out at the Department of Gynecology in a tertiary medical center in Tel Aviv. Patients undergoing elective gynecological laparotomies during two periods of time and who were treated with two different antisepsis protocols were included. The protocols for antisepsis were povidone-iodine 10% scrub followed by 10% povidone-iodine in 65% alcohol ( n = 145) and chlorhexidine 2% followed by 70% alcohol ( n = 111). The rate of SSIs as defined by the Centers for Disease Control and Prevention (CDC), and the risk factors for the occurrence of SSIs were calculated. Results: Antisepsis with chlorhexidine and alcohol was associated with a reduction in the overall rate of SSIs from 14.6% to 4.5% compared with the povidone-iodine protocol ( p = 0.011). The two groups of patients were similar in regard to baseline characteristics and medical history. Surgical procedures as well as the type of cut, drains, and tension suture use were similar in the two groups. Patients with SSIs tended to be older and heavier. Risk factors found to be associated with SSIs were hypertension, noninsulin-dependent diabetes mellitus (NIDDM), immunodeficiency, and the use of the povidone-iodine antisepsis protocol. Conclusions: This retrospective study demonstrates that antisepsis with chlorhexidine and alcohol was associated with a significant reduction in the rate of SSIs compared to povidone-iodine antisepsis in patients undergoing elective gynecological laparotomies. This is of extreme clinical importance, as a change in antisepsis protocol can significantly reduce the morbidity and healthcare costs associated with patients undergoing elective gynecological surgery. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Women's Health (15409996) is the property of Mary Ann Liebert, Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Chlorhexidine and Alcohol Versus Povidone-Iodine for Antisepsis in Gynecological Surgery.
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  Data: <searchLink fieldCode="DE" term="%22Surgical+site+infections%22">Surgical site infections</searchLink><br /><searchLink fieldCode="DE" term="%22Surgical+site+infection+prevention%22">Surgical site infection prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Povidone-iodine%22">Povidone-iodine</searchLink><br /><searchLink fieldCode="DE" term="%22Chlorhexidine%22">Chlorhexidine</searchLink><br /><searchLink fieldCode="DE" term="%22Ethanol%22">Ethanol</searchLink><br /><searchLink fieldCode="DE" term="%22Abdominal+surgery%22">Abdominal surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Academic+medical+centers%22">Academic medical centers</searchLink><br /><searchLink fieldCode="DE" term="%22Analysis+of+variance%22">Analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Bactericides%22">Bactericides</searchLink><br /><searchLink fieldCode="DE" term="%22Chi-squared+test%22">Chi-squared test</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Epidemiology%22">Epidemiology</searchLink><br /><searchLink fieldCode="DE" term="%22Fisher+exact+test%22">Fisher exact test</searchLink><br /><searchLink fieldCode="DE" term="%22Gynecologic+surgery%22">Gynecologic surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+analysis%22">Regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22T-test+%28Statistics%29%22">T-test (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Israel%22">Israel</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Surgical site infections (SSIs) cause severe morbidity and are associated with tremendous health costs. Skin antisepsis (cleansing) with chlorhexidine and alcohol solutions has demonstrated superiority to povidone-iodine in a variety of surgical interventions. Our objective was to determine if chlorhexidine and alcohol antisepsis protocol reduces the rate of SSIs in elective gynecological laparotomies compared with povidone-iodine antisepsis. Methods: This retrospective study was carried out at the Department of Gynecology in a tertiary medical center in Tel Aviv. Patients undergoing elective gynecological laparotomies during two periods of time and who were treated with two different antisepsis protocols were included. The protocols for antisepsis were povidone-iodine 10% scrub followed by 10% povidone-iodine in 65% alcohol ( n = 145) and chlorhexidine 2% followed by 70% alcohol ( n = 111). The rate of SSIs as defined by the Centers for Disease Control and Prevention (CDC), and the risk factors for the occurrence of SSIs were calculated. Results: Antisepsis with chlorhexidine and alcohol was associated with a reduction in the overall rate of SSIs from 14.6% to 4.5% compared with the povidone-iodine protocol ( p = 0.011). The two groups of patients were similar in regard to baseline characteristics and medical history. Surgical procedures as well as the type of cut, drains, and tension suture use were similar in the two groups. Patients with SSIs tended to be older and heavier. Risk factors found to be associated with SSIs were hypertension, noninsulin-dependent diabetes mellitus (NIDDM), immunodeficiency, and the use of the povidone-iodine antisepsis protocol. Conclusions: This retrospective study demonstrates that antisepsis with chlorhexidine and alcohol was associated with a significant reduction in the rate of SSIs compared to povidone-iodine antisepsis in patients undergoing elective gynecological laparotomies. This is of extreme clinical importance, as a change in antisepsis protocol can significantly reduce the morbidity and healthcare costs associated with patients undergoing elective gynecological surgery. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Women's Health (15409996) is the property of Mary Ann Liebert, Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=104845025
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1089/jwh.2010.2391
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 4
        StartPage: 321
    Subjects:
      – SubjectFull: Surgical site infections
        Type: general
      – SubjectFull: Surgical site infection prevention
        Type: general
      – SubjectFull: Povidone-iodine
        Type: general
      – SubjectFull: Chlorhexidine
        Type: general
      – SubjectFull: Ethanol
        Type: general
      – SubjectFull: Abdominal surgery
        Type: general
      – SubjectFull: Academic medical centers
        Type: general
      – SubjectFull: Analysis of variance
        Type: general
      – SubjectFull: Bactericides
        Type: general
      – SubjectFull: Chi-squared test
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Epidemiology
        Type: general
      – SubjectFull: Fisher exact test
        Type: general
      – SubjectFull: Gynecologic surgery
        Type: general
      – SubjectFull: Health outcome assessment
        Type: general
      – SubjectFull: Regression analysis
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      – SubjectFull: T-test (Statistics)
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      – SubjectFull: Data analysis
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      – SubjectFull: Retrospective studies
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      – SubjectFull: Disease risk factors
        Type: general
      – SubjectFull: Therapeutics
        Type: general
      – SubjectFull: Israel
        Type: general
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      – TitleFull: Chlorhexidine and Alcohol Versus Povidone-Iodine for Antisepsis in Gynecological Surgery.
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              Text: Mar2011
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