Comparison of Povidone-Iodine against a Combination of Chlorhexidine, Cetrimide, and Methylated Spirit Skin Preparation for Clean-Contaminated Laparotomy Operations at Jos University Teaching Hospital

Abstract

Abstract Background: Surgical site infection is a major cause of post-operative morbidity and mortality, and pre-operative skin preparation is a measure taken to reduce it. The agents used for skin preparation are either chlorhexidine-based or iodine-based, with no consensus on the ideal pre-operative skin preparation method. Objective: To compare the surgical site infection rate for clean-contaminated laparotomy operations when pre-operative skin preparation was done with 10% povidone-iodine or with a combination of chlorhexidine, cetrimide (Savlon), and methylated spirit at Jos University Teaching Hospital. Materials and Methods: This was a retrospective study, and patients’ information was accessed from their medical records. Data was analysed using Statistical Package for Social Sciences version 22 statistical software. Comparison of qualitative variables was analysed using Fisher’s exact test and quantitative variables with Student’s t test. The level of significance was at 0.05, and the confidence interval of 95% when the surgical site infection (SSI) rates were compared. Results: Seventy-five patients were enrolled into the study, 36 (48%) were in the povidone-iodine group, while 39 (52%) were in the chlorhexidine group. In all, three (8.3%) patients from the povidone-iodine group developed SSI, while for the chlorhexidine group, it was 3 (7.7%). There was no statistically significant difference in the SSI rate between the two groups ( P = 0.919). Conclusion: There was no significant difference in the SSI rate between the povidone-iodine and chlorhexidine method of skin preparation. Hence, either of the two methods could be used for clean-contaminated laparotomies.