Meta-analysis of the use of antiseptics for pre-operative showering to prevent surgical site infection

Webster, Joan & Osborne, Sonya (2006) Meta-analysis of the use of antiseptics for pre-operative showering to prevent surgical site infection. British Journal of Surgery, 93(11), pp. 1335-1341.

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Background: Preoperative bathing or showering with an antiseptic solution is used to prevent surgical site wound infection. Conflicting trial results suggest a critical review is necessary. Methods: We systematically reviewed randomized controlled trials. Studies were identified by computer searches of Medline, Embase and the Cochrane controlled trials register. Trials were eligible if they compared pre-operative bathing or showering using an antiseptic solution with a non-antiseptic wash agent or with no shower, and if they reported data on surgical site infection. Results: Six trials involving a total of 10,007 participants were included. 4% chlorhexidine gluconate (Hibiscrub) was used in all trials. Three trials involving 7691 participants compared Hibiscrub with a placebo. Bathing with chlorhexidine did not reduce surgical site wound infection rate; the relative risk (RR) was 0.91 (95% confidence interval (CI) 0.80 to 1.04). When only trials of high quality were included in this comparison, the RR was 0.95 (95% CI 0.82 to 1.10). Three trials of 1443 participants compared bar soap with chlorhexidine; no differences in the surgical site infection rates were detected, the RR was 1.02 (95% CI 0.57 to 1.84). Two trials of 1092 patients compared bathing with chlorhexidine with no washing. The surgical site wound infection rate in the two groups was similar, the RR was 0.70 (95% CI 0.19 to 2.58). Conclusions: Current evidence does not support pre-operative showering or bathing with chlorhexidine to reduce surgical site wound infection rates.

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15 citations in Web of Science®
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ID Code: 11168
Item Type: Journal Article
Refereed: Yes
DOI: 10.1002/bjs.5606
ISSN: 0007-1323
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2006 John Wiley & Sons
Copyright Statement: The definite version is available on publication at
Deposited On: 10 Dec 2007 00:00
Last Modified: 29 Feb 2012 13:26

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