Chlorhexidine Wound Irrigation for the Prevention of Early Surgical Site Infection in Orthopaedic Surgeries in Resource-Limited Settings: A Randomized Controlled Trial.

Background and objectives Surgical site infections (SSIs) in orthopaedic surgeries continue to pose significant challenges, leading to increased morbidity and strain on healthcare resources especially in resource-limited countries. Intra-operative wound irrigation is a common practice globally, although evidence supporting this practice is lacking. We aimed to determine the preventative effective of chlorhexidine gluconate (CHG) for prevention of early SSIs in orthopaedic surgeries. Methods This is a prospective randomized controlled interventional clinical trial which was designed at National Hospital Abuja, Abuja, Nigeria. A total of 50 patients were enrolled and randomized into two groups: one receiving 0.05% CHG solution and the other receiving isotonic 0.9% saline for wound irrigation. The incidence of early SSIs (within 30 days) postoperatively was the primary outcome measured. Patients and outcome assessors were blinded to intervention allocation. Results The results showed no significant difference in the clinical profile of the patients in both groups. There was a similar rate of early SSIs between the CHG (4%) and isotonic saline (4%) groups. Conclusions There is no significant difference between CHG and isotonic 0.9% saline in preventing early SSIs in clean orthopaedic implant surgeries. These data will improve care and allow appropriate allocation of scarce resources in resource-limited settings.