Chlorhexidine-alcohol versus povidone-iodine as preoperative skin preparation to prevent surgical site infection: a meta-analysis

  • Tasya Anggrahita Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Aditya Wardhana Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Gentur Sudjatmiko Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Keywords: chlorhexidine-alcohol, povidone-iodine, skin antisepsis, surgical site infection
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Background: Surgical site infection remains substantial problems to surgeons and patients as it increases the morbidity, mortality, length of stay, hospital cost, rate of re-admission, and rate of re-surgery. This study aims to compare the use of chlorhexidine-alcohol versus povidone-iodine for preoperative skin preparation to prevent surgical site infection.

Methods: The literature search was conducted through the PubMed database on November 2015. Included studies were RCTs with the year of publication up to 2015 which compared the use of chlorhexidine-alcohol versus povidone-iodine in its effectiveness reducing surgical site infection in adult patients. The quality of the study was assessed using Jadad Score. A meta-analysis was conducted in the included study to obtain a pooled estimate of the effect size. The evidence of heterogeneity and publication bias was also assessed.

Results: Six RCTs with a total of 2,080 patients were included in the meta-analysis. It showed that the use of chlorhexidine-alcohol was associated significantly with fewer SSIs (pooled risk ratio=0.60 (95% CI=0.45-0.79)) and fewer positive skin culture results (pooled risk ratio, RR=0.38 (95% CI=0.28-0.51)) compared with povidone iodine.

Conclusion: Preoperative skin antisepsis with chlorhexidine is more effective than povidone-iodine in preventing surgical site infection.


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How to Cite
Anggrahita T, Wardhana A, Sudjatmiko G. Chlorhexidine-alcohol versus povidone-iodine as preoperative skin preparation to prevent surgical site infection: a meta-analysis. Med J Indones [Internet]. 2017May16 [cited 2024Jul.23];26(1):54-1. Available from:
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