A COMPARATIVE STUDY OF PREVALENCE OF SURGICAL SITE INFECTION USING POVIDONE IODINE VS CHLORHEXIDINE ALCOHOL IN PREOPERATIVE SKIN PREPARATION IN ABDOMINAL HERNIAS

Abstract

Background: Surgical site infections (SSIs) are among the most common complications following abdominal surgeries, including hernia repairs. These infections significantly contribute to patient morbidity and healthcare burden, especially in resource-limited settings. Preoperative skin antisepsis is a critical factor in SSI prevention, with agents such as povidone iodine (PI) and chlorhexidine alcohol (CA) frequently used. However, their comparative efficacy in reducing SSI rates remains an area of clinical interest, necessitating further exploration.

Objective: To compare the prevalence of SSIs in patients undergoing preoperative skin preparation with povidone iodine versus chlorhexidine alcohol during abdominal hernia repair.

Methods: This comparative non-randomized controlled trial was conducted at CMH, Rawalpindi, from May 2022 to February 2023. A total of 300 patients scheduled for hernia repair were enrolled and divided equally into two groups: group A (PI) and group B (CA). Group allocation was performed using a single-blinded technique to minimize bias. Preoperative skin preparation was conducted with a 10% PI solution for group A and a CA solution (2% chlorhexidine in 70% alcohol) for group B. Patients were followed up for 30 days post-surgery to evaluate the presence of SSIs, defined as purulent discharge, fever, elevated white blood cell count, swelling, or erythema at the surgical site. Data were analyzed using SPSS version 22, with statistical significance set at p ≤ 0.05.

Results: The study included 300 patients with a mean age of 40.42 ± 8.71 years, of whom 124 (41.30%) were male and 176 (58.70%) were female. The overall SSI frequency was 69 (23.00%). SSI was significantly higher in the PI group compared to the CA group, with rates of 34.00% (51/150) versus 12.00% (18/150), respectively (p < 0.001).

Conclusion: Chlorhexidine alcohol is significantly more effective than povidone iodine in reducing the prevalence of SSIs in abdominal hernia surgeries. Its use should be preferred for preoperative skin antisepsis to improve surgical outcomes.