Effectiveness of Chlorhexidine – Alcohol Compared with Povidone Iodine for Preventing Surgical Site Infection: A Randomized Trial

Abstract

Background Common agents for surgical site skin preparation are povidone iodine and alcohol based chlorhexidine /Cetrimide. The effectiveness of one over the other remains debatable. Our objective was to determine the effectiveness of alcohol-based chlorhexidine/cetrimide mixture compared with povidone iodine for preventing surgical site infection Methods All clean contaminated general and urological surgeries were recruited into the study. Patients were randomized into two groups (A & B) using GraphPad Cals. Alcohol-based chlorhexidine/cetrimide solution was assigned group A while povidone iodine solution was assigned group B. The rate of surgical site infection in each group was compared using hi-squared test. P < 0.05 was considered statistically significant. Results A total of 90 patients were allocated to each group of povidone iodine and alcohol based – chlorhexidine/cetrimide mixture/.The duration of the procedures ranged from 0.5-3hours in the povidone iodine group with a mean of 1.28 +/0.81 hours, and from 0.5 to 4 hours in the alcohol –chlorhexidine/ cetrimide mixture group, with a mean of 1.9 +/ 1.03 hours. The rate of surgical site infection among the povidone iodine and alcohol – chlorhexidine/cetrimide mixture group were 5.5% and 1.6% (relative risk RR=0.3) respectively. (p< 0.001). Conclusions This study has established that the rate of SSI was lower in patients that had alcohol–chlorhexidine/cetrimide skin preparation. This may be a pointer to the effectiveness of alcohol-based chlorhexidine/cetrimide mixture compared to povidone iodine. Lower incidence of SSI may lead to reduction in post-operative hospital stay.