New! Sign up for our free email newsletter.
Science News
from research organizations

Antisepsis agents interchangeable in reducing infection risk in open fracture surgeries

Date:
October 14, 2022
Source:
Louisiana State University Health Sciences Center
Summary:
A new study compares the effectiveness of two antisepsis aqueous solutions in reducing the risk of infection in patients requiring surgery for open fractures. The research team found that contrary to current international recommendations, chlorhexidine gluconate was not superior to povidone-iodine in an alcohol or aqueous solution in preventing surgical site infection. The results suggest health care practitioners can select either aqueous-based antisepsis solution when treating open fractures on the basis of solution availability, patient contraindications, or product cost.
Share:
FULL STORY

Orthopaedics faculty at LSU Health New Orleans participated in a study comparing two antisepsis aqueous solutions in reducing the risk of infection in patients requiring surgery for open fractures. In the largest known randomized-controlled trial, the research team found that contrary to current international recommendations, chlorhexidine gluconate was not superior to povidone-iodine in an alcohol or aqueous solution in preventing surgical site infection. The results suggesting health care practitioners can select either aqueous-based antisepsis solution when treating open fractures on the basis of solution availability, patient contraindications, or product cost are published in The Lancet, available here.

Robert Zura, MD, Professor and Head of Orthopaedics, and Jessica Rivera, MD, PhD, Associate Professor of Orthopaedics, at LSU Health New Orleans School of Medicine, are also co-authors on the paper.

The authors highlight WHO estimates of millions of patients worldwide each year who have surgical site infections. The inherent risk of using fracture fixation in a contaminated or dirty wound is realized in about 10% of open fractures developing surgical site infections. Orthopaedic surgical procedures have the highest infection rate, greater than 20% for severe open tibia shaft fractures.

Previous reviews of general surgery, obstetrics and gynecology trials suggested the superiority of chlorhexidine over iodine. The Aqueous-PREP multiple-period, cluster-randomized,

crossover trial included 14 hospitals in Canada, Spain and the United States and 1,638 adults who underwent surgery for an open extremity fracture. It found that the odds of surgical site infection or unplanned fracture-related reoperations did not differ between patients assigned to receive skin antisepsis with aqueous 10% povidone or aqueous 4% chlorhexidine gluconate. The authors wrote, "Our findings contrast the superiority of chlorhexidine in alcohol that has been shown in clean or clean-contaminated surgery."

The authors note their findings could have particular relevance to low- and middle-income countries, where both antiseptic solutions might not be readily available or procuring both products is unnecessarily costly.

They conclude, "Our findings are not only relevant to the management of open fractures but might also be applicable to the surgical treatment of other traumatic wounds."


Story Source:

Materials provided by Louisiana State University Health Sciences Center. Note: Content may be edited for style and length.


Journal Reference:

  1. PREP-IT Investigators. Aqueous skin antisepsis before surgical fixation of open fractures (Aqueous-PREP): a multiple-period, cluster-randomised, crossover trial. The Lancet, 2022 DOI: 10.1016/S0140-6736(22)01652-X

Cite This Page:

Louisiana State University Health Sciences Center. "Antisepsis agents interchangeable in reducing infection risk in open fracture surgeries." ScienceDaily. ScienceDaily, 14 October 2022. <www.sciencedaily.com/releases/2022/10/221014135624.htm>.
Louisiana State University Health Sciences Center. (2022, October 14). Antisepsis agents interchangeable in reducing infection risk in open fracture surgeries. ScienceDaily. Retrieved April 17, 2024 from www.sciencedaily.com/releases/2022/10/221014135624.htm
Louisiana State University Health Sciences Center. "Antisepsis agents interchangeable in reducing infection risk in open fracture surgeries." ScienceDaily. www.sciencedaily.com/releases/2022/10/221014135624.htm (accessed April 17, 2024).

Explore More

from ScienceDaily

RELATED STORIES