Background

Chlorhexidine and povidone-iodine are the most common disinfectants used in preoperative skin preparation. However, there is no consistent conclusion regarding the prevention of surgical site infection (SSI) and bacterial culture data.

Objective

To assess the efficacy of chlorhexidine and povidone-iodine in the prevention of postoperative SSI and relevant bacterial data.

Design

Systematic Review and Meta-Analysis

Settings

N/A

Participants

N/A

Method

Literature relevant to “skin antisepsis” and “surgical site infections” was retrieved from PUBMED, Web of Science, EMBASE, CINHAL and CNKI. The incidence of SSI was the primary outcome, while the secondary outcome was bacterial data from the infected incision. All data were analyzed with Revman 5.3 and Stata Statistical Software.

Results

A total of 36 studies were identified in this study, which included 16,872 participants. This study revealed that chlorhexidine is superior to povidone-iodine in the prevention of postoperative SSI (risk ratio [RR], 0.73; 95% confidence interval [CI], 0.61–0.87; p = 0.019, I² = 39%). Further meta-regression analysis revealed that the effect of chlorhexidine was directly associated with the type of incision, but failed to differentiate between the subgroups divided according to the type of incision. With respect to bacteria colonization, the most common bacteria for chlorhexidine arm were propionibacterium's, while the most common bacteria for the iodine arm were staphylococci species.

Conclusion

In comparison to povidone-iodine, chlorhexidine showed better results in preventing postoperative SSI.

中文翻译：

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洗必泰和碘制剂减少手术部位感染的疗效比较：系统评价和荟萃分析

背景

洗必泰和聚维酮碘是术前皮肤准备中最常用的消毒剂。然而，关于预防手术部位感染（SSI）和细菌培养数据，还没有一致的结论。

客观的

评估洗必泰和聚维酮碘预防术后 SSI 的疗效和相关细菌数据。

设计

系统评价和荟萃分析

设置

不适用

参与者

不适用

方法

从 PUBMED、Web of Science、EMBASE、CINHAL 和 CNKI 检索到与“皮肤防腐”和“手术部位感染”相关的文献。SSI 的发生率是主要结果，而次要结果是来自感染切口的细菌数据。所有数据均使用 Revman 5.3 和 Stata Statistical Software 进行分析。

结果

本研究共确定了 36 项研究，其中包括 16,872 名参与者。这项研究表明，洗必泰在预防术后 SSI 方面优于聚维酮碘（风险比 [RR]，0.73；95% 置信区间 [CI]，0.61-0.87；p  = 0.019，I ²  = 39%）。进一步的荟萃回归分析显示，洗必泰的作用与切口类型直接相关，但未能区分根据切口类型划分的亚组。在细菌定植方面，洗必泰组最常见的细菌是丙酸杆菌，而碘组最常见的细菌是葡萄球菌。

结论

与聚维酮碘相比，洗必泰在预防术后 SSI 方面表现出更好的效果。