A comparison study of preoperative skin preparation using chlorhexidine vs povidone iodine in cases of elective orthopaedic surgery

Abstract

Preoperative skin preparation is an inalienable part of the patient preparation in any orthopaedic surgery. The obvious goal of this step is to reduce the possibility of a postoperative wound infection. Unfortunately, guidelines/recommendations to achieve these goals are still to be universally agreed upon. The aim of the study was to determine a preferred method for preoperative skin preparation in clean surgeries for closed fractures. We compared the postoperative infection rates in 120 orthopaedic cases managed with elective surgery, which had undergone preoperative skin preparation with either chlorhexidine or povidone iodine. The effect of each method of skin preparation was studied. Results were analyzed statistically The overall rate of surgical site infection was considerably lower in the chlorhexidine group (12.3%) than in the povidone iodine group (6.66%, p=0.008), while the cost of the antiseptics wasn't different. This study demonstrates that antisepsis with chlorhexidine and was associated with a significant reduction in the rate of SSIs compared to povidone-iodine antisepsis. Hence, Chlorhexidine antiseptics should be the preferred choice for preoperative skin preparation in elective cases of orthopaedic surgery.