Objective: To compare the incidence of SSI(surgicl site infection) betweenanti-sepsis solutions Chlorhexidine-Alcohol (CA) and
Povidone-Iodine (PI) before elective CS(cesarean section).
Methods: Aprospective randomised controlled trial was conducted from January 2018 tell February, 2019 at the Obstetrics
and Gynecology department of King Abd AL-Aziz Hospital, Saudi Arabia. Pregnant women greater than 18 years andreached 37
week of gestation andwere scheduled for elective cesarean delivery wererecruitmed. These womenwere randomly allocated in the
ratio of 1:1 and received skin anti-septic preparation A (Chlorhexidine-Gluconate) or B (Povidone-Iodine). The primary outcome
was superficial or deep SSI within 30 days after elective CS while the secondary outcomes assessed were hospital length of stay,
readmission, endometritis and adverse skin reactions.
Results: There were 490 pregnant women indicated for elective CS randomized to CA group, while 493 to PI group. Significant
difference was observed in SSI betweenCA and PI group (4.3% vs. 7.7%; p-value = 0.014). Moreover, difference was also significant in
superficial SSI between the two groups (2.9% vs. 5.9%; p-value = 0.030). However, significant difference was not observed for deep
SSI between the two groups (1.4% vs. 2.4%; p-value = 0.362). Among the secondary outcomes, significant difference was observed
in the mean hospital stay (4.89 vs. 5.67; p-value = 0.001), while no significant difference was observed in hospital readmission and
endometritis between the two groups. In conclusionChlorhexidine-Alcohol for pre-operative skin anti-sepsis in elective CS was
associated with significantly lower risk SSI when compared to Povidone-Iodinesolution.
Keywords:Cesarean section; Surgical site infection; Chlorhexidine-Alcohol; Povidone-Iodine