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SMFM: Chlorhexidine-Alcohol Best for Pre-Op Skin Antisepsis

Superior to iodine-alcohol for the prevention of surgical-site infection after cesarean delivery

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THURSDAY, Feb. 4, 2016 (HealthDay News) -- For women undergoing cesarean delivery, chlorhexidine-alcohol is superior to iodine-alcohol for preoperative skin antisepsis, according to a study published online Feb. 4 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the Society for Maternal-Fetal Medicine, held from Feb. 1 to 6 in Atlanta.

Methodius G. Tuuli, M.D., M.P.H., from the Washington University School of Medicine in St. Louis, and colleagues conducted a single-center randomized trial to examine whether use of chlorhexidine-alcohol was superior to use of iodine-alcohol for preoperative skin antisepsis for the prevention of surgical-site infection after cesarean delivery. A total of 1,147 patients undergoing cesarean delivery were randomized to skin preparation with chlorhexidine-alcohol (572 patients) or iodine-alcohol (575 patients).

The researchers found that surgical-site infection was diagnosed in 4.0 percent of patients in the chlorhexidine-alcohol group and 7.3 percent in the iodine-alcohol group in an intention-to-treat analysis (relative risk, 0.55; P = 0.02). The rates of superficial surgical-site infection were 3.0 and 4.9 percent, respectively, in the chlorhexidine-alcohol and iodine-alcohol groups (P = 0.10); deep skin infections occurred in 1.0 and 2.4 percent, respectively (P = 0.07). The groups had similar frequency of adverse skin reactions.

"The use of chlorhexidine-alcohol for preoperative skin antisepsis resulted in a significantly lower risk of surgical-site infection after cesarean delivery than did the use of iodine-alcohol," the authors write.

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