Evidence map›Paper›PMID 41497165›Full record

ArticleAnnals of medicine and surgery (2012)2026

Efficacy and safety of chlorhexidine vs. povidone-iodine for vaginal antisepsis in surgery: an updated systematic review and meta-analysis.

Areej Zeeshan Ahmed, Maasfah Tahir, Muhammad Suhaib Hanif, Hamzah Naushad Siddiqui, Sajal Irshad, Khadija Jalal, Jalib Ahmed, Simra Shadab, Yashfa Parveen, Saniha Outmani and 6 more

Abstract read
In one paragraph

Article in Annals of medicine and surgery (2012), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Areej Zeeshan AhmedDepartment of Medicine, Ziauddin University, Karachi, Pakistan.ORCID https://orcid.org/0009-0002-8394-1334
Maasfah TahirDepartment of Medicine, Ziauddin University, Karachi, Pakistan.
Muhammad Suhaib HanifDepartment of Medicine, Dow University of Health and Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0001-0470-3243
Hamzah Naushad SiddiquiDepartment of Medicine, Dow International Medical College, Karachi, Pakistan.ORCID https://orcid.org/0000-0002-2351-6777
Sajal IrshadDepartment of Medicine, Dow University of Health and Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0002-8650-0702
Khadija JalalDepartment of Medicine, Dow University of Health and Sciences, Karachi, Pakistan.
Jalib AhmedDepartment of Medicine, Dow University of Health and Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0001-7705-9890
Simra ShadabDepartment of Medicine, Liaquat National Hospital & Medical College, Karachi, Pakistan.ORCID https://orcid.org/0009-0005-2748-8397
Yashfa ParveenDepartment of Medicine, Akhtar Saeed Medical College, Rawalpindi, Pakistan.
Saniha OutmaniDepartment of Medicine, Liaquat National Hospital & Medical College, Karachi, Pakistan.ORCID https://orcid.org/0009-0005-5402-829X
Ummi Aiman RahmanDepartment of Medicine, King Edward Medical College, Lahore, Pakistan.ORCID https://orcid.org/0009-0007-0119-5857
Wania AhmerDepartment of Medicine, Dow University of Health and Sciences, Karachi, Pakistan.ORCID https://orcid.org/0009-0003-0252-6225
Mohammad Aadil QamarDepartment of Medicine, Ziauddin University, Karachi, Pakistan.ORCID https://orcid.org/0000-0003-3331-6901
Pratik BhattaraiDepartment of Medicine, Manipal College of Medical Sciences, Pokhara, Nepal.ORCID https://orcid.org/0000-0002-9223-7800
Omar IrfanDepartment of Medicine, Aga Khan University Hospital, Karachi, Pakistan.ORCID https://orcid.org/0000-0003-0921-1456
Zohra S LassiSchool of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.ORCID https://orcid.org/0000-0002-5350-6334

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Surgical site infections (SSIs) are significant postoperative complications in gynecologic and obstetric surgeries. Preoperative vaginal antisepsis is vital for prevention. This review compares the efficacy and safety of chlorhexidine gluconate (CHG) vs. povidone-iodine (PI) for vaginal antisepsis in preventing postoperative infections. Materials and Methods: A systematic search of major databases was conducted through 8 Ja-nuary 2025. Randomized controlled trials (RCTs) comparing CHG and PI for vaginal antisepsis during urogynecologic procedures were included. Meta-analyses were performed using random-effects models to estimate risk ratios (RRs) with 95% confidence intervals (CIs). The GRADE approach assessed the certainty of evidence. The primary outcome was SSIs; secondary outcomes included febrile morbidity, hospital stay, antiseptic-related side effects, and wound complications. Results: Twelve RCTs, including 4936 participants, were analyzed. The results showed that CHG significantly reduced compared to PI (RR: 1.71; 95% CI: 1.30-2.26; Conclusion: CHG was superior to PI in preventing SSIs in gynecologic and obstetric surgeries. With high-quality evidence supporting its use, CHG is recommended for vaginal preparation. Future research should explore cost-effectiveness and long-term outcomes.

Indexed as

chlorhexidine gluconategynecologic surgeryobstetric surgerypovidone-iodinepreoperative vaginal antisepsissurgical site infections

Identifiers

PMID41497165
PMCPMC12767958

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Registered trials

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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.