ArticleAnnals of the Royal College of Surgeons of England2016
Does chlorhexidine and povidone-iodine preoperative antisepsis reduce surgical site infection in cranial neurosurgery?
Article in Annals of the Royal College of Surgeons of England, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Chlorhexidine versus povidone-iodine for surgical site infection prevention: an updated meta-analysis and trial sequential analysis of randomized controlled trials.Frontiers in medicine · 2025Pooled it
- Preoperative Antisepsis with Chlorhexidine Versus Povidone-Iodine for the Prevention of Surgical Site Infection: a Systematic Review and Meta-analysis.World journal of surgery · 2020Pooled it
- Epidemiology and risk factors of surgical site infections in elective surgeries in Pakistan (2022-2023): a multicentre, prospective cohort study from PakSurg 1.The Lancet regional health. Southeast Asia · 2026Article
- Transient Corneal Edema in the Second Eye during Immediately Sequential Bilateral Cataract Surgery under General Anesthesia: Two Case Reports.Korean journal of ophthalmology : KJO · 2026Article
- Short-term incidence and risk factors of surgical site infection following trauma orthopaedic surgery in Northern Ghana.International wound journal · 2025Article
- Povidone-iodine-induced scalp lesions in pediatric neurosurgery patients: a case series.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- THE EFFECT OF SKIN ANTISEPSIS AFTER PRIMARY SKIN CLOSURE ON THE INCIDENCE OF SURGICAL SITE INFECTION AFTER ABDOMINAL SURGERY FOR SEPSIS: A PRELIMINARY REPORT OF A RANDOMISED CONTROLLED TRIAL.Annals of Ibadan postgraduate medicine · 2023Article
- The Level of Surface Coverage of Surgical Site Disinfection Depends on the Visibility of the Antiseptic Agent-A Virtual Reality Randomized Controlled Trial.Journal of clinical medicine · 2023Article
- PRE-INCISION SKIN ANTISEPSIS: PRACTICE PATTERNS AMONG SURGEONS IN NIGERIA.Annals of Ibadan postgraduate medicine · 2021Article
- Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control andAntimicrobial agents and chemotherapy · 2020Review
- Current preoperative antisepsis in neurosurgery: an example of the challenges in implementing evidence-based medicine to surgical practice.Annals of the Royal College of Surgeons of England · 2019Article
- Risk factors for surgical site infections in neurosurgery.Annals of the Royal College of Surgeons of England · 2019Article
- Systematic Review and Meta-Analysis of Preoperative Antisepsis with Combination Chlorhexidine and Povidone-Iodine.Surgery journal (New York, N.Y.) · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction Surgical site infection (SSI) is a significant cause of postoperative morbidity and mortality. Effective preoperative antisepsis is a recognised prophylactic, with commonly used agents including chlorhexidine (CHG) and povidone-iodine (PVI). However, there is emerging evidence to suggest an additional benefit when they are used in combination. Methods We analysed data from our prospective SSI database on patients undergoing clean cranial neurosurgery between October 2011 and April 2014. We compared the case-mix adjusted odds of developing a SSI in patients undergoing skin preparation with CGH or PVI alone or in combination. Results SSIs were detected in 2.6% of 1146 cases. Antisepsis with PVI alone was performed in 654 (57%) procedures, while 276 (24%) had CHG alone and 216 (19%) CHG and PVI together. SSIs were associated with longer operating time (p<0.001) and younger age (p=0.03). Surgery type (p<0.001) and length of operation (p<0.001) were significantly different between antisepsis groups. In a binary logistic regression model, CHG and PVI was associated with a significant reduction in the likelihood of developing an SSI (adjusted odds ratio [AOR] 0.12, 95% confidence interval [CI] 0.02-0.63) than either agent alone. There was no difference in SSI rates between CHG and PVI alone (AOR 0.60, 95% CI 0.24-1.5). Conclusions Combination skin preparation with CHG and PVI significantly reduced SSI rates compared to CHG or PVI alone. A prospective, randomized study validating these findings is now warranted.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.