Comparison of Chlorhexidine –Alcohol and Povidone Iodine Skin Preparation Skin Preparation Solutions in Orthopaedic and Trauma Surgery at An African Tertiary Hospital

Abstract

Background: The aim of this study was to compare the efficacy of Povidone-Iodine (PI) and Chlorhexidine-Alcohol (CHG-A) skin preparation solutions in orthopaedic and trauma surgery.

Methods: This prospective randomised study described the bacterial skin flora and compared the bacterial clearance rates by PI and CHG-A in patients undergoing clean orthopaedic surgery at an African tertiary hospital.

Results: There were 50 patients in each group. A baseline positive culture rate of 76.8% was found. Coagulase-negative staphylococcus was the commonest aerobe (42.9%) while Propionibacterium species was the commonest anaerobe (17.3%). The aerobic positive culture rate reduced from 60% to 22% after PI preparation and from 49% to 6.2% after CHG-A preparation (p=0.026). The anaerobic culture rate reduced from 54% to 44% after PI preparation and from 53.1% to 43.8% after CHG-A preparation (p=0.435).The mean log pre-preparation and post-preparation aerobe counts were 7.85/cm2 and 7.50/cm2 respectively in the PI group and 7.62/cm2 and 7.65/cm2 respectively in the CHG-A group (p=0.715). The mean log pre-preparation and post-preparation anaerobe counts were 8.06/cm2 and 7.96/cm2 respectively in the PI group and 7.86/cm2 and 7.84/cm2 respectively in the CHG-A group (p=0.335).

Conclusion: This study did not demonstrate an overall superiority of chlorhexidine-alcohol over povidone-iodine skin preparation solution or vice versa.

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