Estudio comparativo entre clorhexidina alcohólica 2% tintada con aplicador y povidona yodada en la preparación del campo quirúrgico en cirugía limpia de pared abdominal (hernia umbilical y eventración)

Résumé

Introduction. There is sufficient evidence on the greater efficacy of alcoholic chlorhexidine compared to povidone iodine in surgical asepsis in clean-contaminated surgery, but not enough in clean abdominal wall surgery. Objective. To compare the efficacy in the prevention of infection of the surgical site in clean surgery of the abdominal wall after the use of these two antiseptics in the prepa-ration of the operative field. Patients and Methods. Retrospective observational study. The data collection has been done through the electronic medical record. We selected 398 patients randomly operated on for umbilical hernia and ventral hernia from January 2017 to December 2018. They were divided into two groups according to the type of antiseptic used. Povidone iodine 199 group and alcoholic chlorhexidine group 199 patients. The main endpoint is infection of the superficial surgical site, within 30 days after surgery. We analyzed the frequencies and distributions of sex, age, personal history, anesthetic risk, type of intervention, antibiotic prophylaxis, time of intervention, presence of drainage, stay and infectious complication. The results are presented as a mean, stan-dard deviation and variance for the quantitative variables and in related proportions for qualitative variables. The infection rate in the two groups is compared by the Chi2 test with a P value of <0.05 as the confidence interval, to assess whether the difference between the two antiseptics in clean surgery is statistically significant. The statistical analysis was carried out using the SPSS pro-gram. Results. The age of the patients, sex, personal history, anesthetic irrigation, type of pathology, antibiotic prophylaxis, time of intervention, the presence of drainage, stay, the type of surgical intervention and the pattern of use of prophylactic antibiotics in both groups did not show statistically significant differences (p> 0.05), which shows the homogeneity of the groups and therefore comparable. Five (2.5%) patients developed surgical site infection in the povidone-iodine group and 3 (1.5%) patients in the al-coholic chlorhexidine group. Enterobacteria were the most frequent pathogens cultured in infected wounds. Conclusion. Although the infection rate of the surgical site in the alcoholic chlorhexidine group is lower with respect to the povidone-iodine group, the statistical analysis shows that this difference is not statistically significant (p = 0.7210); therefore, these two antiseptics are equally effective for the preparation of the operative field in clean abdominal wall surgery.