Efficacy of different preoperative antiseptics in preventing a risk of surgical site infections: a systematic review and meta‑analysis of randomized controlled trials

TL;DR

This study finds that using 2%–2.5% chlorhexidine in alcohol before surgery is most effective at preventing surgical site infections.

Contribution

The study provides evidence that 2%–2.5% chlorhexidine in alcohol is superior to other antiseptics for preventing surgical site infections.

Findings

2%–2.5% chlorhexidine in alcohol significantly reduces surgical site infection incidence.

It shows significant antimicrobial activity compared to other antiseptic solutions.

The results are based on data from 10,587 patients across 18 clinical trials.

Abstract

Surgical site infection (SSI) is a predominant postoperative complication that markedly increases health care expenses. Published systematic reviews, meta‑analyses and international guidelines vary in their recommendations for the most effective preoperative skin antiseptic solutions and their concentrations.

The aim of this study was to assess the efficacy of different preoperative antiseptics for prevent‑ ing the risk of SSIs.

A complete search was conducted using PubMed, EMBASE, Scopus, and Cochrane Library databases to collect peer‑reviewed articles.

This meta‑analysis included 10 587 surgical patients from 18 randomized clinical trials to determine the effectiveness of chlorhexidine in alcohol (CHA; 0.5%, 2%–2.5%, and 4%) with aqueous or alcoholic iodine in preventing postoperative SSIs. This meta‑analysis found that 2%–2.5% CHA is the most effective preoperative antiseptic for preventing SSIs, with significant reduction in their incidence and significant antimicrobial activity.

The findings of this meta‑analysis indicate that for patients undergoing any type of surgery, the use of 2%–2.5% CHA for skin preparation is the most effective method for preventing SSIs.

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