Surgical solutions for preoperative skin preparation in total hip arthroplasty: A cost-effectiveness analysis of Betadine® and Chloraprep™.

OBJECTIVE

The purpose of our study was to compare the cost of surgical site skin preparation using ChloraPrep™ (2% chlorhexidine gluconate [CHG] and 70% isopropyl alcohol [IPA]) with skin cleansing using Betadine® Surgical Scrub and Betadine® 5% solution (povidone-iodine [PVI]) in total hip arthroplasty (THA).

HYPOTHESIS: The hypothesis was that the ChloraPrep™ skin disinfection protocol reduces the cost of perioperative antisepsis.

METHODS

A prospective database was created for all THAs performed at our university hospital between November 1st, 2020, and December 31st, 2020. Each surgeon was randomly assigned one type of antiseptic prior to the start of the study: one surgeon to the ChloraPrep™ group and one to the Betadine® group. In both groups, the enrollment stopped at the 15th patient. The costs related to consumables, waste disposal, and operating room occupancy time of each protocol were then assessed for each patient.

RESULTS

The mean duration of the ChloraPrep™ protocol was 3.5±0.3minutes compared to 13.5±0.9minutes for the Betadine® protocol. The overall cost of a surgical site skin preparation involving all three steps was on average €46.8±4.2 for the ChloraPrep™ group compared to €155±10.9 for the Betadine® group (p<0.0001).

DISCUSSION: Not only is the effectiveness of ChloraPrep™ already recognized but it also appears to have health economic benefits. However, further studies are needed to confirm this finding.

LEVEL OF EVIDENCE: III, case control study.