Surgical site infections (SSIs) occurring after an operative procedure may present as superficial to deep wound infections. The World Health Organization (WHO) and the Centers for Disease Control (CDC) have issued guidelines recommending actions to prevent SSIs. Intraoperative measures primarily emphasize skin decontamination and intraoperative wound irrigation using soap and antiseptics, which are simple, efficient, and cost-effective measures to reduce SSIs. Povidone-iodine (PVI) is a topical antiseptic widely used to reduce SSIs.

Shi L. et al., in their recent meta-analysis, determined the efficacy of preoperative or intraoperative use of PVI from previously conducted randomized controlled trials (RCTs).

They conducted a systematic literature review using MEDLINE and Central databases for RCTs involving PVI application versus saline or no treatment control groups across various surgical categories and looked for SSI or postoperative wound infections. They used a random-effects model to calculate the pooled risk ratio and performed subgroup analyses.

Their study included 59 RCTs containing information from 20,497 patients. They found a reduction in overall SSI incidence with the use of PVI. In the subgroup analyses, they found that the comparator treatment and type of procedure did not modify the effect of PVI on SSI incidence. However, yhey got inconsistent results on SSI incidence on stratifying data by PVI application method and surgery category.

This meta-analysis provides enough data to support the preoperative or intraoperative use of PVI for decreasing the incidence burden of SSI.

Wideochir Inne Tech Maloinwazyjne. 2022 Jun;17(2):261-278. doi: 10.5114/wiitm.2021.112479.