Effectiveness of chlorhexidine versus povidone‐iodine for preventing surgical site wound infection: A meta‐analysis

Abstract

AbstractA systematic evaluation was conducted to assess the efficacy of two disinfectants, chlorhexidine and povidone‐iodine, as primary components in preventing surgical site infection (SSI). A comprehensive computerised search was performed in the PubMed, EMBASE, Web of Science, Cochrane Library, CNKI and Wanfang databases for randomised controlled trials (RCTs) on chlorhexidine and povidone‐iodine disinfection for the prevention of SSI from inception until July 2023. Two independent researchers completed literature screening, data extraction and quality assessment of the included studies. The meta‐analysis was conducted using RevMan 5.4 software. Ultimately, 20 RCTs were included, which included 13 133 patients, with 6460 patients in the chlorhexidine group and 6673 patients in the povidone‐iodine group. The meta‐analysis results revealed that the incidence rate of surgical site wound infections [odds ratio (OR): 0.67, 95% confidence interval (CI): 0.58–0.78, p < 0.001)], superficial SSI rate (OR: 0.59, 95% CI: 0.46–0.75, p < 0.001) and deep SSI rate (OR: 0.49, 95% CI: 0.31–0.79, p = 0.003) were all lower in patients subjected to chlorhexidine disinfection compared to those patients receiving povidone‐iodine disinfection. Existing evidence suggests that chlorhexidine is more effective than povidone‐iodine at preventing SSI. However, owing to the potential quality limitations of the included studies, further validation through high‐quality large‐scale RCTs is warranted.