Urogynecology (Philadelphia, Pa.) · 2026
Preoperative Vaginal Preparation and Infection After Gynecologic Surgery.
СтатьяНазвание и аннотация: Перевод в очереди
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Samsel Tara, Ashmore Sarah, Gugerty Lindsay, Neal Samantha, Anderson Camara, Shi Jinxuan, Kenton Kimberly, Mueller Margaret G
Аннотация
IMPORTANCE: Current literature insufficiently identifies the optimal preoperative vaginal antiseptic to reduce rates of surgical site infection (SSI) after gynecologic surgery.
OBJECTIVE: The objective of this study was to determine the rate of chlorhexidine vaginal preparation use in gynecologic surgery with and without postoperative SSI compared with iodine.
STUDY DESIGN: We performed a retrospective case-control study of women undergoing any gynecologic surgery between January 2010 and December 2023 at an urban academic medical center. Adult women diagnosed with and treated for a postoperative SSI within 30 days of gynecologic surgery were identified as cases and matched 1:4 to the 2 preceding and 2 subsequent gynecologic surgical procedures performed on the same day without postoperative SSI. Additional SSI risk factors were analyzed as secondary objectives. Standard group comparisons were performed. A multivariable logistic regression was used to assess factors associated with SSI.
RESULTS: SSI cases (n=101) were matched to controls (n=404). Cases and controls differed on numerous baseline and intraoperative characteristics, including insurance type, American Society of Anesthesiologists physical status, comorbidities, malignancy, surgical route, major/minor surgery, estimated blood loss, intraoperative complications, and operative time. Cases were less likely to undergo chlorhexidine vaginal preparation (11% vs 26%, P <0.01) and more likely to have a non-SSI postoperative complication (32.7% vs 7.0%, P <0.01), readmission (17.0% vs 4.3%, P <0.01), and reoperation (17.2% vs 0%, P <0.01). In a backwards regression, chlorhexidine vaginal preparation was associated with significantly lowered odds (adjusted odds ratio, 0.4, 0.17-0.89) of SSI after gynecologic surgery.
CONCLUSION: Patients undergoing chlorhexidine vaginal preparation before gynecologic surgery had a 60% decreased odds of SSI within 30 days of surgery.
OBJECTIVE: The objective of this study was to determine the rate of chlorhexidine vaginal preparation use in gynecologic surgery with and without postoperative SSI compared with iodine.
STUDY DESIGN: We performed a retrospective case-control study of women undergoing any gynecologic surgery between January 2010 and December 2023 at an urban academic medical center. Adult women diagnosed with and treated for a postoperative SSI within 30 days of gynecologic surgery were identified as cases and matched 1:4 to the 2 preceding and 2 subsequent gynecologic surgical procedures performed on the same day without postoperative SSI. Additional SSI risk factors were analyzed as secondary objectives. Standard group comparisons were performed. A multivariable logistic regression was used to assess factors associated with SSI.
RESULTS: SSI cases (n=101) were matched to controls (n=404). Cases and controls differed on numerous baseline and intraoperative characteristics, including insurance type, American Society of Anesthesiologists physical status, comorbidities, malignancy, surgical route, major/minor surgery, estimated blood loss, intraoperative complications, and operative time. Cases were less likely to undergo chlorhexidine vaginal preparation (11% vs 26%, P <0.01) and more likely to have a non-SSI postoperative complication (32.7% vs 7.0%, P <0.01), readmission (17.0% vs 4.3%, P <0.01), and reoperation (17.2% vs 0%, P <0.01). In a backwards regression, chlorhexidine vaginal preparation was associated with significantly lowered odds (adjusted odds ratio, 0.4, 0.17-0.89) of SSI after gynecologic surgery.
CONCLUSION: Patients undergoing chlorhexidine vaginal preparation before gynecologic surgery had a 60% decreased odds of SSI within 30 days of surgery.