A randomized clinical trial of chlorhexzidine alcohol 4% compared with povidin Iodine 10% for vaginal scrub in gynecologic surgeries: complications and microbial flora

Abstract

Infections at the surgical site cause many complications, a significant increase in mortality, long-term hospitalization, and increased hospital costs. The aim of this study is to comparation of chlorhexzidine alcohol 4% compared with povidin Iodine 10% for vaginal scrub in gynecologic surgeries in terms of complications and microbial flora. Materials and Methods: In this study, which was performed as a randomized controlled clinical trial, the target population included all patients who referred to the operating room during a 6-month period in 2019 in Al-Zahra Hospital in Tabriz. 100 patients who underwent vaginal surgery were enrolled in two groups of 50: vaginal scrub with 10% povidin Iodine and chlorhexzidine alcohol 4% method. Participants were selected by convenience sampling method and randomly entered into one of the two study groups using a random numbered table in two-sided blinds without the knowledge of the researcher and the patient. Then each patient in three stages, before the operation, immediately after the operation site scrub (in the first minute) with antiseptic solution and then at the end of the operation using a sterile swab, samples were taken from the vaginal walls and fornixes and transferred to a transport environment and sent to laboratory for microbial culture. The operation site was examined for local complications such as burning, inflammation, redness, scaling and ulceration, immediately after the use of antiseptic, at the end of the operation and in the morning after the operation by a trained nurse and recorded in the check list. Results: In this study, the mean (standard deviation) age of the two groups of chlorhexidine and betadine was 40.88 (±9.4) and 42.56 (±12.3) years, respectively. The result of culture before surgery in terms of the number of bacteria in the chlorhexidine group were 11 cases (22.0%) negative, 1 cases (2.0%) less than one hundred and 38 cases (76.0%) more than 100 thousand, respectively. Also, the result of culture before surgery in terms of the number of bacteria in the betadine group were 11 cases (22.0%) negative and 36 cases (72.0%) more than one hundred thousand, respectively. The result of culture during surgery in terms of the number of bacteria in the chlorhexidine group were 50 cases (100.0%) negative. Also, the result of culture during surgery in terms of the number of bacteria in the betadine group were 33 cases (66.0%) negative, 2 cases (4.0%) less than one hundred thousand and 14 cases (28.0%) more than one hundred thousand, respectively. The result of culture after surgery in terms of the number of bacteria in the chlorhexidine group were 49 cases (98.0%) negative and 1 cases (2.0%) more than 100 thousand, respectively. Also, the result of culture after surgery in terms of the number of bacteria in the betadine group were 22 cases (44.0%) negative, 5 cases (10.0%) less than one hundred thousand and 21 cases (42.0%) more than one hundred thousand, respectively.