Chlorhexidine Gluconate vs Povidone-Iodine in the Prevention of Clean-Contaminated Surgical Site Infections
Erin Layne; Abigail Stone
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Abby Massey, MD
Date of Graduation
A patient’s skin is the major source of pathogens that can cause post-operative complications such as surgical site infections (SSIs). Optimization of pre-operative skin antisepsis is obtained with chlorhexidine gluconate (CG) and povidone-iodine (PI). These two solutions are the most widely used antiseptics for pre-operative purposes.
Among surgical patients greater than 18 years of age undergoing clean-contaminated surgery, which antiseptic, iodophors or chlorhexidine gluconate, is more effective at reducing postoperative surgical site infections?
A search was done in PubMed utilizing the terms chlorhexidine, infection control, iodophors, and surgical site infection. The limits applied included randomized controlled trial, published within 10 years, and humans.
Darouiche et al found that the application of 2% CG reduced the incidence of SSIs by 41% compared to 10% PI. This study demonstrated statistical significance (p = 0.0049). Bibi et al found a 45.4% reduction in SSI rates with the use of 2% CG compared to 10% PI but was not statistically significant (p =0.3961). Park et al found no difference between 2% CG and 10% PI regarding the reduction of SSIs (p= 0.8532).
There is not a significant difference between the rates of SSIs when using CG compared to PI in the setting of clean-contaminated surgeries. Future research should be conducted to determine if a significant difference is present, and if there is a difference in efficacy of antiseptics in the settings of clean and contaminated wounds. CG and PI may be used interchangeably depending on presence of allergy, cost, and convenience.
Layne E, Stone A. Chlorhexidine Gluconate vs Povidone-Iodine in the Prevention of Clean-Contaminated Surgical Site Infections. JMU Scholarly Commons Physician Assistant Capstones. https://commons.lib.jmu.edu/pacapstones. Published December 11, 2019.
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