Effects of povidone-iodine wound irrigation on surgical site infection in gastroenterological surgery: A randomized controlled trial

Surgery. 2024 Aug;176(2):371-378. doi: 10.1016/j.surg.2024.04.034. Epub 2024 Jun 1.

Abstract

Background: The irrigation efficacy of a povidone-iodine solution to prevent surgical site infection is still controversial. We assessed the irrigation effect with a povidone-iodine solution on the incidence of surgical site infection after gastroenterological surgery.

Methods: This study is a single-center, prospective, randomized, blinded-end point superiority trial for surgical wound irrigation. Patients undergoing gastroenterological surgery were randomly assigned in a 1:1 replacement ratio using computer-generated randomization. Patients were grouped according to their surgical wound treatment into the control group using the normal sterile saline and the povidone-iodine group using 10% povidone-iodine solution after the NS solution. The main finding was 30-day surgical site infections assessed in the full analysis set.

Results: From November 2020 to December 2022, 697 of 894 patients were eligible for the study, among which 347 were in the povidone-iodine group and 350 in the control group. Thirty-day surgical site infections occurred in 100 (14%) patients-54 (16%) in the povidone-iodine group and 46 (13%) in the control group (odds ratio, 1.229; 95% CI, 0.800-1.889; P = .406). Superficial incisional surgical site infections occurred in 30 (9%) and 15 (4%) patients, respectively (odds ratio, 2.154; 95% CI, 1.134-4.090; P = .026). Only 3 patients (1%) in the control group developed adverse skin reactions.

Conclusion: This study examined the irrigation efficacy of povidone-iodine for surgical site infection prevention compared to control in gastroenterological surgery. Povidone-iodine wound irrigation has shown no additional beneficial effect on the occurrence of surgical site infections.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents, Local* / administration & dosage
  • Digestive System Surgical Procedures* / adverse effects
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Povidone-Iodine* / administration & dosage
  • Povidone-Iodine* / therapeutic use
  • Prospective Studies
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / etiology
  • Surgical Wound Infection* / prevention & control
  • Therapeutic Irrigation* / methods
  • Treatment Outcome

Substances

  • Povidone-Iodine
  • Anti-Infective Agents, Local