A Randomized Trial Comparing Skin Antiseptic Agents at Cesarean Delivery

• Published in: The New England journal of medicine Vol. 374; no. 7; pp. 647 - 55
• Main Authors: Tuuli, Methodius G, Liu, Jingxia, Stout, Molly J, Martin, Shannon, Cahill, Alison G, Odibo, Anthony O, Colditz, Graham A, Macones, George A
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 18-02-2016
• Subjects: Adult; Anti-Infective Agents, Local - adverse effects; Anti-Infective Agents, Local - therapeutic use; Antimicrobial agents; Antisepsis - methods; Cesarean Section; Chlorhexidine; Chlorhexidine - adverse effects; Chlorhexidine - therapeutic use; Clinical trials; Evidence-based medicine; Female; Humans; Infections; Iodine; Iodine - adverse effects; Iodine - therapeutic use; Motivation; Pathogens; Pregnancy; Prevention; Skin; Skin - drug effects; Surgical site infections; Surgical Wound Infection - prevention & control
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1511048

In this single-center trial comparing chlorhexidine–alcohol with iodine–alcohol for skin antisepsis before cesarean delivery, the use of chlorhexidine–alcohol resulted in a risk of surgical-site infection that was significantly lower than that associated with iodine–alcohol.
Cesarean delivery is the most common major surgical procedure among women in the United States.
1
In 2013, more than 32.7% (1.3 million) of the 3.9 million births were by cesarean section.
2
Surgical-site infections complicate 2 to 5% of all surgical procedures and 5 to 12% of cesarean deliveries.
3
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6
Infection occurring after delivery places an extra burden on the new mother and may impair mother–infant bonding and breast-feeding. The average attributable hospital cost per surgical-site infection after cesarean delivery is estimated to be $3,529.
7
The skin is a major source of pathogens that cause surgical-site infections. Therefore, preoperative skin antisepsis . . .