Efficacy of Prophylactic Intraoperative Povidone-Iodine Solution Irrigation in Preventing Surgical Site Infection Following Spinal Surgery

Abstract

Objective:  Deep wound infection can worsen clinical outcome and increase costs following spinal surgery. The bactericidal activity of povidone-iodine covers a broad spectrum of pathogens including methicillin-resistant Staphylococcus aureus. Our study aimed at evaluating the role that intraoperative dilute povidone-iodine solution irrigation could play in preventing post-operative wound infection following spinal surgery. Material and Methods:  The clinical data of 41 patients that had undergone posterior spinal surgery in the department of neurosurgery Allama Iqbal hospital Sialkot was retrospectively analyzed. We divided the patients into two groups. In group 1patients wounds were irrigated with 0.35% povidone-iodine solution prior to closure. In group 2 patients wounds were irrigated with normal saline only. The two groups were then compared for evaluation of efficacy of peroperative povidone-iodine solution irrigation in preventing post-operative wound infection. Results:  No infection occurred in the 16 patients in group 1 in whom wounds had been irrigated with povidone-iodine solution, compared to 3 deep infections developing in the 25 patients in group 2 in whom wounds had been irrigated with normal saline only. In the 3 patients that suffered from deep infections the duration of hospital stay was also significantly increased (P < 0.05). Conclusion:  Our study supports the notion that perioperative povidone-iodine irrigation is an effective adjunct measure for prevention of surgical site infection following spinal surgical interventions.