Chlorhexidine gluconate (CG) and povidone iodine (PI) are the two most commonly used skin disinfectants. Currently there are no published studies comparing the efficacy of these two agents for cesarean section (C/S). The objective of this study was to compare the incidence of positive bacterial cultures post C/S after preoperative application of CG versus PI.
Gravidas undergoing scheduled C/S at term were randomly assigned to receive CG or PI. A culture swab was taken of the incisional site at 3 minutes and 18 hours after application of the disinfectant, and were placed on mammalian blood-enriched agar with 10^2 size loop (Agar A) and 10^3 loop (Agar B) for semiquantitative cultures. The main outcome of interest was the presence of positive bacterial culture. Continuous variables were compared using Mann-Whitney; categorical variables were compared using Chi-Square or Fishers exact tests.
The two groups were similar in age, BMI, and past medical history. Of the 30 patients, 13 were randomized to CG and 17 to PI. No differences in positive bacterial culture rates were detected between the two groups at 3 minutes. At 18 hours, positive bacterial cultures were identified in 15% (2/13) in the CG group versus 59% (10/17) in the PI group (p=.016) in Agar A, and 0% (0/13) in the CG group versus 41% (7/17) in the PI group (p=0.008) in Agar B.
The rate of incisional site positive bacterial cultures obtained 18 hours after cesarean section was significantly less in the CG group compared to the PI group. Further study is required to assess if the preoperative use of CG results in a decreased rate of C/S wound infections.
© 2012 Mosby, Inc. Published by Elsevier Inc. All rights reserved.