Comparison of chlorhexidine with povidone – iodine solution for skin disinfection in epidural and central venoues catheter insertion
DOI:
https://doi.org/10.18203/2349-3933.ijam20160198Keywords:
Chlorhexidine, Povidone- iodine solution, Skin disinfection, Catheter insertionAbstract
Background: Chlorhexidine and povidone – iodine solution are both well-known skin disinfectants. In this study we have compared the efficacy of chlorhexidine against povidone – iodine solution.
Methods: 100 patients undergoing elective surgeries were divided into 2 groups of 50 each. Group CHD was cleansed with chlorhexidine gluconate 2% in 80% alcohol and group PV-I group was treated with 10% aqueous solution of povidone iodine. Two swabs were taken from the site of surgery, one before skin disinfection and one after and sent to the microbiology lab where they were cultured on Mac Conkey and Blood Agar and the magnitude of growth was reported.
Results: The demographic details of both the groups were similar. 19 patients and 13 patients in the CHD and PV-I groups had growth prior to disinfection, while after disinfection, there was no bacterial growth in any of the patients in CHD group and 2 patients had poor growth in PV-I group.
Conclusions: Though both the disinfectants were very effective, CHD was slightly better than PV-I. The cost and side effects were similar in both the cases. Since the drying time of CHD was faster than that of PV-I, CHD was a better choice, especially in emergency cases.
References
Anderson DJ, Harris A, Baron EL, Sexton DJ., Epidemiology of surgical site infections in adults: Available at http://www.uptodate.com/contents/epidemiology-of-surgical-site-infection-in-adults.
Wolf JS, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ. Best practice policy statements on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379-90.
Hawn MT, Itani KM, Gray SH, Vick CC, Henderson W, Houston TK. Association of timely administration of prophylactic antibiotics for major surgical procedures and surgical site infection. J Am Coll Surg. 2008;206:814-9.
Belda FJ, Aguilera L, Garcia de la Asunción J, et al. Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA. 2005;294:2035-42.
Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med. 1996;334:1209-15.
Consensus paper on the surveillance of surgical wound infections. The Society for Hospital Epidemiology of America; The Association for Practitioners in Infection Control; The Centers for Disease Control; The Surgical Infection Society. Infect Control Hosp Epidemiol. 1992;13:599.
Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13:606.
Ingram P, Lavery I. Peripheral intravenous therapy: Key risks and implications for practice. Nurs Stand.2005;19:55-64.
Mullany LC, Khatry SK, Sherchand JB, LeClerq SC, Darmstadt GL, Katz J, et al. A randomized controlled trial of the impact of chlorhexidine skin cleansing on bacterial colonization of hospital-born infants in Nepal. Pediatr Infect Dis J. 2008;27:505-11.
Perry CM. Infection prevention and control. Oxford: Blackwell;2007.
Frasca D, Dahyot-Fizelier C, Mimoz O. Prevention of central venous catheter-related infection in the intensive care unit. Crit Care. 2010;14:212.
Valles J, Fernandez I, Alcaraz D, Chacon E, Cazorla A, Canals M, et al. Prospective randomized trial of 3 antiseptic solutions for prevention of catheter colonization in an intensive care unit for adult patients. Infect Control Hosp Epidemiol. 2008;29:847-53.
Garland JS, Alex CP, Uhing MR, Peterside IE, Rentz A, Harris MC. Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates. J Perinatol. 2009;29:808-13.
Kulkarni AP, Awode RP. A prospective randomised trial to compare the efficacy of povidone-iodine 10% and chlorhexidine 2% for skin disinfection. Indian J Anaesth. 2013;57(3):270-5.
Fleischer W, Reimer K. Povidone-iodine in antisepsis – State of the art. Dermatology. 1997;195:3-9.
Milstone AM, Passaretti CL, Perl TM. Chlorhexidine: Expanding the armamentarium for infection control and prevention. Clin Infect Dis. 2008;46:274-81.
Anderson MJ, Horn ME, Lin YC, Parks PJ, Peterson ML. Efficacy of concurrent application of chlorhexidine gluconate and povidone iodine against six nosocomial pathogen. Am J Infect Control. 2010;38(10):826-31.
Suwanpimolkul G, Pongkumpai M, Suankratay C. A randomized trial of 2% chlorhexidine tincture compared with 10% aqueous povidone-iodine for venipuncture site disinfection: Effects on blood culture contamination rates. J Infect. 2008;56:354-9.
Grewal S, Hocking G, Wildsmith JA. Epidural abscesses. Br J Anaesth. 2006;96:292-302.
Eggimann P, Pittet D. Overview of catheter-related infections with special emphasis on prevention based on educational programs. Clin Microbiol Infect. 2002;8:295-309.
Majidipour N, Abdeyazdan Z, Zargha-Boroujeni A. Chlorhexidine or povidone-iodine: Which solution is more effective on skin colonization in neonates? Iran J Nurs Midwifery Res. 2013;18(1):54-8.
Khera SY, Kostyal DA, Deshmukh N. A comparison of chlorhexidine and povidone-iodine skin preparation for surgical operations. Curr Surg. 1999;56:341-3.