Comparative Evaluation of Pre Operative Skin Preparation of 4% Chlorhexidine With 5% Povidone Iodine in Prevention of Abdominal Surgical Site Infections – A One Year Randomized Controlled Trial At KLES Dr Prabhakar Kore Hospitals

Abstract

Background and Objectives ABSTRACT Surgical Site Infections is a dangerous condition, a heavy burden on the patient and social health system. The use of pre operative 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 4% Chlorhexidine versus 5% Povidone Iodine in abdominal surgeries for prevention of SSI. Methodology The present one year randomized controlled trial was conducted in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum over a period from January 2010 to December 2010 on 120 patients undergoing elective abdominal surgeries. The patients were divided into two groups by computer randomization that is Group A (Chlorhexidine group) and Group B (Povidone Iodine group). Samples from skin were collected and quantitative bacterial cultures were done. 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 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% group B) was the most common organism IX isolated after skin preparation. After the application of antiseptic agents there was reduction of bacterial colonization 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 and interpretation Preoperative skin cleansing with chlorhexidine significantly reduces risk of postoperative SSIs and colonization of bacteria in abdominal surgeries.