Efficacy of different preoperative antiseptics in preventing a risk of surgical site infections: a systematic review and meta‑analysis of randomized controlled trials

Abstract

INTRODUCTION Surgical site infection (SSI) is a predominant postoperative complication that markedly increases health care expenses. Published systematic reviews, meta‑analyses and international guidelines vary in their recommendations for the most effective preoperative skin antiseptic solutions and their concentrations.AIM The aim of this study was to assess the efficacy of different preoperative antiseptics for preventing the risk of SSIs.MATERIALS AND METHODS A complete search was conducted using PubMed, EMBASE, Scopus, and Cochrane Library databases to collect peer‑reviewed articles.RESULTS This meta‑analysis included 10 587 surgical patients from 18 randomized clinical trials to determine the effectiveness of chlorhexidine in alcohol (CHA; 0.5%, 2%–2.5%, and 4%) with aqueous or alcoholic iodine in preventing postoperative SSIs. This meta‑analysis found that 2%–2.5% CHA is the most effective preoperative antiseptic for preventing SSIs, with significant reduction in their incidence and significant antimicrobial activity.CONCLUSIONS The findings of this meta‑analysis indicate that for patients undergoing any type of surgery, the use of 2%–2.5% CHA for skin preparation is the most effective method for preventing SSIs.