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Antiseptics Work Equally Well in Preventing Infection After Surgery for Open Fractures

10 percent povidone-iodine and aqueous 4 percent chlorhexidine gluconate demonstrated similar efficacy in preventing infection after surgical fixation of open fractures

WEDNESDAY, Nov. 2, 2022 (HealthDay News) — Both 10 percent povidone-iodine and aqueous 4 percent chlorhexidine gluconate are equally effective for preventing postsurgical infections among patients requiring surgery for open fractures, according to a study published in the Oct. 15 issue of The Lancet.

Gerard Slobogean, M.D., from University of Maryland School of Medicine in Baltimore, and colleagues compared the effect of aqueous 10 percent povidone-iodine versus aqueous 4 percent chlorhexidine gluconate on the risk for surgical site infection in patients who required surgery for an open fracture. The analysis included 1,683 adults treated with a surgical fixation implant for an open extremity fracture at one of 14 hospitals in Canada, Spain, and the United States (April 8, 2018, to June 8, 2021).

The researchers found that a surgical site infection occurred in 59 of 787 participants randomly assigned to the povidone-iodine group and 58 of 784 randomly assigned to the chlorhexidine gluconate group (odds ratio, 1.11; 95 percent confidence interval, 0.74 to 1.65; P = 0.61; risk difference, 0.6 percent; 95 percent confidence interval, –1.4 to 3.4).

“Many surgeons prefer to use povidone-iodine skin preparation for open fractures because of its wide availability as an effective aqueous solution,” Slobogean said in a statement. “Our findings should reassure surgeons that either antiseptic solution is fine to use, and they can base their decision on product availability, cost, or patient contraindications.”

Several authors disclosed financial ties to the medical device industry.

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