Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone–iodine in clean-contaminated surgery

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Abstract
Background: Surgical‐site infection increases morbidity, mortality and financial burden. The preferred topical antiseptic agent (chlorhexidine or povidone–iodine) for preoperative skin cleansing is unclear. Methods: A meta‐analysis of clinical trials was conducted to determine whether preoperative antisepsis with chlorhexidine or povidone–iodine reduced surgical‐site infection in clean‐contaminated surgery. Results: The systematic review identified six eligible studies, containing 5031 patients. Chlorhexidine reduced postoperative surgical‐site infection compared with povidone–iodine (pooled odds ratio 0·68, 95 per cent confidence interval 0·50 to 0·94; P = 0·019) . Conclusion: Chlorhexidine should be used preferentially for preoperative antisepsis in clean‐contaminated surgery. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.