Senior Lecturer in Farm Animal Surgery University of Bern Bern, Bern, Switzerland
Preoperative Skin Antisepsis with Chlorhexidine Versus Povidone-Iodine in Veterinary Surgery: A Systematic Review and Meta-Analysis. Marchionatti E1, Constant C2, Steiner A1. 1University of Bern, Vetsuisse Faculty, Farm Animal Clinic, Bern, Switzerland; 2AO Research Institute Davos, AO Foundation, Davos, Switzerland.
Postoperative surgical site infections (SSI) represent a major economic and welfare burden in veterinary surgery. Currently, chlorhexidine (CHX) and povidone-iodine (PVI)-based products are the most used preoperative skin antiseptics in veterinary surgery. Despite studies in human surgery have shown superiority of CHX compared to PVI, the choice of preoperative skin antiseptic remains a puzzling problem in veterinary surgery as the preoperative skin antiseptic with best efficacy is still unknown. The aim of this systematic review and meta-analysis was to evaluate the efficacy of preoperative skin antisepsis with CHX compared to PVI for the prevention of postoperative SSI and reduction of skin bacterial colonization. A literature search was performed in February 2021. The literature search yielded 1,119 results; a total of 14 studies were judged eligible and included in the meta-analysis. Meta-analysis indicated no statistically significant difference in the incidence of postoperative SSI, for the presence/absence of skin bacterial colonization at the immediate or delayed timepoints, nor for the immediate or delayed percentage of bacterial colonization between preoperative antisepsis with CHX versus PVI. No statistical difference was found when analyses were sub-grouped by animal species. Insufficient methodology information and detail was frequent among studies and precluded a clear assessment of bias. This study showed no evidence in favor of CHX preoperative skin antisepsis in veterinary surgery compared with PVI in the prevention of postoperative SSI or in reducing bacterial colonization of the skin.