The effectiveness of intraoperative povidone-iodine (PVP-I) application in reducing surgical-site infection (SSI) remains controversial. The present meta-analysis assessed the effect of intraoperative PVP-I application compared with no antiseptic solution (saline or nothing) on the SSI rate.

It included randomized controlled trials that compared intraoperative PVP-I lavage with no PVP-I in patients undergoing surgery with SSI as the primary outcome, and found-

• The study included twenty-four randomized controlled trials with 5004 patients (2465 patients with PVP-I and 2539 patients without PVP-I): 15 in the main analysis and nine in the sensitivity analysis.
• 8.0% rate of SSI in the PVP-I group and 13.4% in the control group.
• Significant decrease in the SSI rate after intraoperative PVP-I application.
• Consistent results in subgroup analyses according to the method of PVP-I administration, its timing, and the type of surgery.

The meta-analysis results suggest that using intraoperative PVI can effectively reduce SSI rates.

Fournel I, Tiv M, Soulias M, Hua C, Astruc K, Aho Glélé LS. Meta-analysis of intraoperative povidone-iodine application to prevent surgical-site infection. Br J Surg. 2010 Nov;97(11):1603-13. doi: 10.1002/bjs.7212. PMID: 20878943.