Subcutaneous rifampicin versus povidone-iodine for the prevention of incisional surgical site infections following gynecologic oncology surgery - a prospective, randomized, controlled trial

Abstract

Objectives: Surgical site infection (SSI) following gynecologic oncology surgery is a severe problem for both patient and surgeon in terms of increasing morbidity, length of hospital stay, anxiety, and costs. In this prospective, randomized, controlled study we investigated the effect of subcutaneous rifampicin and povidone-iodine on incisional SSI following gynecologic oncology surgery. Material and methods: Three hundred patients scheduled for abdominal surgery due to any malign gynecological pathology were randomly assigned into one of three groups of 100 members each, as follows: the subcutaneous tissue was irrigated with saline in Group 1; saline + 10% povidone iodine in Group 2; saline + rifampicin in Group 3. Patients were invited to follow-up once every 10 days in a 30-day period for evaluation. Patients who developed a superficial incisional SSI were recorded. Results: No significant relationship was observed between the SSI and the subcutaneous agents used (p = 0.332). It was observed that there was a statistically significant increase in the rate of incisional surgical site infections as the period of hospitalization (p = 0.044), patient's age (p = 0.003), existence of comorbidities (p = 0.001), and perioperative blood transfusion (p = 0.021) increased. Conclusions: Subcutaneous agents are not effective in preventing surgical site infections after gynecologic oncology surgeries. Further large-scale prospective randomized controlled studies may provide other options to prevent SSIs.