Background and Objective Chlorhexidine (CH) and povidone-iodine (PI) are the most commonly used preoperative skin antiseptics at present. However, the prevention of the surgical site infection (SSI) and the incidence of skin adverse events do not reach a consistent statement and conclusion. This meta-analysis aimed to evaluate the efficacy of chlorhexidine and povidone-iodine in the prevention of postoperative surgical site infection and the incidence of corresponding skin adverse events. Method Substantial studies related to ''skin antiseptic'' and ''surgical site infection'' were consulted on PUBMED, Web of Science, EMBASE, and CNKI. The primary outcome was the incidence of postoperative SSI. The secondary outcome was associated with skin adverse events. All data were analyzed with Revman 5.3 software. Results A total of 30 studies were included, including 29,006 participants. This study revealed that chlorhexidine was superior to povidone-iodine in the prevention of postoperative SSI (risk ratio [RR], 0.65; 95% confidence interval [CI], 0.55-0.77; p \ 0.00001, I 2 = 57%). Further subgroup analysis showed that chlorhexidine was superior to povidone-iodine in the prevention of postoperative SSI in clean surgery (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.67-0.98; p = 0.03), I 2 = 28%) and clean-contaminated surgery (risk ratio [RR], 0.58; 95% confidence interval [CI], 0.47-0.73; p \ 0.00001, I 2 = 43%). However, there was no statistically significant difference in the incidence of skin adverse events between CH and PI groups. Conclusion Chlorhexidine was superior to povidone-iodine in preventing postoperative SSI, especially for the cleancontaminated surgery. However, there was no statistically significant difference in the incidence of skin adverse events between CH and PI groups.

Objective: To explore the clinical efficacy and safety of small incision open reduction and intramedullary nail internal fixation surgery in the treatment of simple tibial shaft fracture compared to the closed reduction surgery. Methods: A total of fifty patients with simple tibial shaft fractures admitted to our hospital were randomly and equally assigned into the observation group and the control group. Patients in the observation group received small incision open reduction surgery with intramedullary nail while patients in the control group received the closed reduction surgery. The clinical efficacy, prognosis as well as safety profile were compared between the two groups. Results: Our data indicated that the average bleeding volume of patients in the observation group was increased while the operation time was decreased compared to the control group. No significant difference of postoperative complications, fracture healing time, and Johner-Wruhs scores was identified between the two groups. Conclusion: The small incision open reduction surgery can significantly shorten the operation time while achieved a similar clinical efficacy compared to the closed reduction surgery in simple tibial shaft fracture.