537. Comparison of Efficacy Between Chlorhexidine and Povidone Iodine as Abdominal Skin Preparation Among Women Undergoing Cesarean Section and Exploratory Laparotomy for Ectopic Pregnancy: A Randomized Trial
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: The purpose of this study was to compare the efficacy of chlorhexidine and povidone iodine for cleansing the operative field for abdominal deliveries and exploratory laparotomy for ectopic pregnancy.
Methods: This was a randomized controlled trial that compared 0.2% chlorhexidine digluconate and povidone iodine 7.5% scrub followed by 10% paint as surgical site antiseptics. Primary outcome measured were postoperative fever and surgical site infection. The wounds were inspected 1, 2, 3, 7 and 14 days postoperatively. The agent used during the pre-operative antiseptic was continued during the postoperative wound dressing.
Results: A total of 552 patients were enrolled between March and August 2008. There were no difference in the demographic and perioperative characteristics between the povidone iodine (n=277) and chlorhexidine (n=275) groups. The only variable observed to be significantly different was place of operation with 92.4% of operation being performed at OB Admitting Section among the chlorhexidine group (vs 84.5% in povidone iodine group). Results on the analysis of intent to treat data were comparable with that of complete data. There was no significant difference in the incidence of fever on 3, 7 and 14 days postoperatively between the povidone iodine group and chlorhexidine group. Likewise, there was no significant difference in the incidence of surgical site infection on 3 and 14 days post-operatively between the two study groups. However, there was a significant difference in the incidence of surgical site infection 7 days post-operatively, occurring in 7.63% and 2.75% under the complete data (p=.0132), 6.9% and 2.6% under the positive outcome assumption (p=.0168), and in 16.6% and 7.6% under the negative outcome assumption (p=.0013) for povidone iodine and chlorhexidine group, respectively.
Conclusion: It appears that chlorhexidine is superior to povidone iodine in the control of surgical site infection 7 days after abdominal delivery and exploratory laparotomy for ectopic pregnancy.
Analyn Fallarme, OB-GYN, IDS, University of the Philippines-Philippine General Hospital, Manila City, Philippines and  A. F. Fallarme, None.