American journal of surgery · 2025
A comparative meta-analysis of povidone-iodine-alcohol vs. chlorhexidine-alcohol for preoperative skin antisepsis in abdominal surgery.
СтатьяМетаанализСравнительное исследованиеОбзорНазвание и аннотация: Перевод пока не подготовлен
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Hsieh Hua-Hsin, Yu Yueh, Chang Che-Jui, Chang Tzu-Yen
Аннотация
INTRODUCTION: Abdominal surgeries are among the most frequently performed procedures globally and exhibit higher surgical site infection (SSI) rates, with associated complications significantly impacting morbidity and mortality. While alcohol-based antiseptics effectively reduce SSIs, debate persists over the relative efficacy of chlorhexidine-alcohol versus iodine-alcohol solutions. This meta-analysis systematically compares SSI rates in abdominal surgeries using these antiseptics, aiming to inform optimal preoperative practices.
METHODS: A comprehensive search was conducted across the Cochrane Library, Embase, and MEDLINE databases to identify relevant studies. Meta-analysis was performed using the metafor package in R software, wherein risk ratios (RRs) for surgical site infections (SSIs) were compared between chlorhexidine-alcohol and iodine-alcohol groups in patients undergoing abdominal surgeries. Subgroup analyses were conducted based on wound classification and procedural categories, including general surgery and obstetrics/gynecology. A random-effects model was utilized, with effect sizes presented alongside their 95 % confidence intervals (CIs).
RESULTS: Our meta-analysis included 10 randomized controlled trials and found no significant difference in SSI risk between chlorhexidine-alcohol and iodine-alcohol in abdominal surgeries (RR, 1.20; 95 % CI, 0.94-1.54). Subgroup analyses for general surgery, obstetrics/gynecology, and clean-contaminated wounds also showed no significant differences between antiseptics.
CONCLUSION: This meta-analysis indicates no significant difference in SSI incidence between chlorhexidine-alcohol and iodine-alcohol as preoperative antiseptics for abdominal surgeries.
METHODS: A comprehensive search was conducted across the Cochrane Library, Embase, and MEDLINE databases to identify relevant studies. Meta-analysis was performed using the metafor package in R software, wherein risk ratios (RRs) for surgical site infections (SSIs) were compared between chlorhexidine-alcohol and iodine-alcohol groups in patients undergoing abdominal surgeries. Subgroup analyses were conducted based on wound classification and procedural categories, including general surgery and obstetrics/gynecology. A random-effects model was utilized, with effect sizes presented alongside their 95 % confidence intervals (CIs).
RESULTS: Our meta-analysis included 10 randomized controlled trials and found no significant difference in SSI risk between chlorhexidine-alcohol and iodine-alcohol in abdominal surgeries (RR, 1.20; 95 % CI, 0.94-1.54). Subgroup analyses for general surgery, obstetrics/gynecology, and clean-contaminated wounds also showed no significant differences between antiseptics.
CONCLUSION: This meta-analysis indicates no significant difference in SSI incidence between chlorhexidine-alcohol and iodine-alcohol as preoperative antiseptics for abdominal surgeries.