Clinical Evaluation of Preoperative Skin Preparation With Aqueous Povidone Iodine Only and in Combination With Alcholic Chlorhexidine in Patients Undergoing Elective and Emergency Surgeries

Abstract

Many techniques are there for skin preparation before surgery, the commonest being initial scrub with antiseptic soap solution, followed by painting the prepared area with antiseptic paint solution. But degerming of the skin can be done with antiseptics used for less than one minute which is as effective as five minute scrub with germicidal soap solution followed by painting with antiseptics. AIMS AND OBJECTIVES: 1. To evaluate the efficacy of povidone iodine alone and antiseptic agent containing alcoholic chlorhexidine with povidone iodine in preoperative skin preparation by taking swab culture. 2. To compare the rate of postoperative wound infection in both the groups. METHODS: STUDY DESIGN: Comparative study conducted on 100 patients in two groups. STUDY SETTING: Sri Venkateswara Medical College Tirupathi SOURCE OF DATA: 100 Patients (50 in each Group) undergoing elective and emergency surgery admitted in the Department of General Surgery in S.V.R.R. Government General Hospital, Tirupati from 2013 to 2014. INCLUSION CRITERIA: 1. Patients undergoing elective & emergency surgery in department of general surgery. 2. Patients with no focus of infection anywhere on the body. 3. Patients irrespective of their age and sex. 4. Patients neither immunocompromised nor on any long term steroids. 5. Patients undergoing mesh repair of hernia are also included. EXCLUSION CRITERIA: 1. Immuno compromised patients and patients on long term steroids. 2. Patients with septicemia. 3. Patients suffering from malignancies or undergoing chemotherapy or radiation therapy. 4. Contaminated surgeries in which viscus was opened were excluded from the study. 5. Patients with co-morbid medical conditions like diabetes, hypertension etc. METHOD OF COLLECTION OF DATA: In each case preoperatively, detailed history was taken and routine investigations like haemoglobin, total count, differential count, ESR, RBS and chest X-ray, ultrasound were done to rule out any co-morbid conditions, chronic infections or malignancy. Preoperative shaving of the parts was done at the same time on previous evening for all the patients and same antibiotic protocol was followed. The pre-operative skin preparation in each group is done with the respective antiseptic regimen. Group I: Three coats of aqueous povidone iodine IP 5% w/v marketed as Betadine. Group II: Chlorhexidine gluconate 2.5% v/v in 70% propanol followed by two coats of aqueous povidone iodine IP 5% w/v. In both the groups after application of antiseptics, sterile saline swab culture was taken immediately from site of incision and was transferred to microbiology department to determine