Previous studies comparing alcoholic and aqueous preparations for prevention of surgical site infection
| Study, date and location | Study details* | Study arm; incidence of infection, n/N (%) | RR (95% CI) | ARR, % | p value | |
|---|---|---|---|---|---|---|
| Alcoholic | Aqueous | |||||
| Abreu et al. (36) (2014), Uruguay | 56 participants, clean contaminated Intervention: 0.5% alcoholic CHG Control: 0.5% aqueous PVI | 6/32 (18.8) | 4/24 (16.7) | 1.13 | +2.2 | NS |
| Bibbo et al. (26) (2005), USA | 127 participants, clean Intervention: 4% CHG scrub + 70% alcohol paint Control: 7.5% aqueous PVI scrub + 10% aqueous PVI paint | 0/60 (0.0) | 0/67 (0.0) | NA | 0.0 | NA |
| Brown et al. (27) (1984), USA† | 737 participants, clean, clean contaminated + contaminated Intervention: 0.5% CHG in 70% alcohol spray Control: 0.7% aqueous PVI scrub + aqueous PVI paint | 23/378 (6.1) | 29/359 (8.1) | 0.75 (0.44 to 1.28) | −2.0 | NS |
| Darouiche et al. (6) (2010), USA | 849 participants, clean contaminated Intervention: 2% CHG in 70% alcohol scrub Control: 10% aqueous PVI scrub + paint | 39/409 (9.5) | 71/440 (16.1) | 0.59 (0.41 to 0.85) | −6.6 | 0.004 |
| Gilliam et al. (28) (1990), USA‡ | 60 participants, clean Intervention: 0.7% iodophor in 74% alcohol paint Control: Aqueous iodophor scrub + paint | 0/30 (0.0) | 0/30 (0.0) | NA | 0.0 | NA |
| Howard (33) (1991), USA‡ | 159 participants, clean Intervention: alcoholic iodophor Control: aqueous iodophor scrub + paint | 2/84 (2.4) | 2/75 (2.7) | 0.89 (0.13 to 6.18) | −0.3 | NS |
| Meier et al. (30) (2001), Nigeria‡ | 200 participants, clean Intervention: bath soap scrub + methylated spirit paint Control: aqueous PVI scrub + paint | 5/98 (5.1) | 6/102 (5.9) | 0.87 (0.27 to 2.75) | −0.8 | NS |
| Paocharoen et al. (29) (2009), Thailand† | 500 participants, clean, clean contaminated + contaminated Intervention: 4% CHG in 70% alcohol scrub + paint Control: aqueous PVI scrub + paint | 5/250 (2.0) | 8/250 (3.2) | 0.63 (0.21 to 1.88) | −1.2 | NS |
| Paocharoen et al. (29) (2009), clean surgeries only, Thailand‡ | 183 participants, clean Intervention: 4% CHG in 70% alcohol scrub + paint Control: aqueous PVI scrub + paint | 2/96 (2.1) | 5/87 (5.7) | 0.36 (0.07 to 1.82) | −3.6 | NS |
| Roberts et al. (35) (1995), USA‡ | 200 participants, clean Intervention: alcoholic iodophor Control: aqueous iodophor scrub + paint | 10/104 (9.6) | 9/96 (9.4) | 1.03 (0.44 to 2.42) | +0.2 | NS |
| Saltzman et al. (32) (2009), USA | 150 participants, clean Intervention 1: 2% CHG in 70% alcohol Intervention 2: 0.7% iodophor in 74% alcohol Control: 0.75% PVI scrub + 1% PVI paint | Int 1: 0/50 (0.0) Int 2: 0/50 (0.0) | 0/50 (0) | NA | 0.0 | NA |
| Segal and Anderson (25) (2002), USA‡ | 209 participants, clean Intervention 1: alcoholic iodophor Intervention 2: alcoholic iodophor + incise drape§ Control 1: 10% aqueous PVI paint Control 2: 7.5% aqueous PVI scrub + 10% aqueous PVI paint | Int 1: 1/50 (2.0) | Control 1: 7/56 (12.5) Control 2: 7/52 (13.5) | 0.16 0.15 | −10.5 −11.5 | NS |
| Sistla et al. (31) (2010), India‡ | 556 participants, clean Intervention: 2.5% CHG in 70% alcohol paint Control: 10% aqueous PVI paint | 14/200 (7.0) | 19/200 (9.5) | 0.74 | −2.5 | NS |
| Srinivas et al. (34) (2015), India | 351 participants, clean contaminated Intervention: 0.5% CHG in 70% alcohol paint Control: 5% aqueous PVI paint | 17/158 (10.8) | 33/184 (17.9) | 0.60 | −7.1 | NS |
Note: ARR = absolute risk reduction, CHG = chlorhexidine, CI = confidence interval, NA = not available, NS = no statistically significant difference between intervention and control (p value not reported), PVI = povidone iodine, RR = relative risk.
↵* “Clean” = noncontaminated wound; “clean contaminated” = operative wound in respiratory, alimentary or genitourinary tract, or minor break in aseptic technique; “contaminated” = open, fresh, accidental wound, acute nonpurulent inflammation, gross spillage from gastrointestinal tract or major break in aseptic technique. (37)
↵† Data supplemented by analyses performed in systematic review of literature by Maiwald and colleagues. (2)
↵‡ Data supplemented by analyses performed in systematic review of literature by Dumville and colleagues. (1)
↵§ Data from this group were excluded from analysis because of use of incise drape as an additional intervention.