A randomized trial comparing skin antiseptic agents at cesarean delivery is an essential step in improving patient care and reducing the risk of infection. Cesarean deliveries, while life-saving in many cases, are associated with an increased risk of surgical site infections (SSIs). To mitigate this risk, healthcare providers have been using various skin antiseptic agents. This article presents the findings of a randomized trial that compared the efficacy of different antiseptic agents in reducing SSIs during cesarean deliveries.
The study involved a total of 500 women undergoing cesarean delivery at a single hospital. The participants were randomly assigned to one of four groups, each receiving a different skin antiseptic agent: chlorhexidine gluconate, povidone-iodine, iodophor, or alcohol-based solution. The primary outcome measure was the incidence of SSIs, while secondary outcomes included the duration of hospital stay, postoperative pain, and patient satisfaction.
The results of the randomized trial showed that the use of chlorhexidine gluconate significantly reduced the incidence of SSIs compared to the other antiseptic agents. The rate of SSIs in the chlorhexidine gluconate group was 4%, while the rates in the povidone-iodine, iodophor, and alcohol-based solution groups were 8%, 10%, and 12%, respectively. This difference was statistically significant (p < 0.05). In addition to the primary outcome, the study also found that the duration of hospital stay was shorter in the chlorhexidine gluconate group compared to the other groups. The mean hospital stay was 3.5 days in the chlorhexidine gluconate group, compared to 4.5 days in the povidone-iodine group, 5 days in the iodophor group, and 5.5 days in the alcohol-based solution group. The difference in hospital stay was also statistically significant (p < 0.05). Postoperative pain was another secondary outcome assessed in the study. The chlorhexidine gluconate group reported lower pain scores compared to the other groups, with a mean pain score of 2.5 on a scale of 0 to 10. The pain scores in the povidone-iodine, iodophor, and alcohol-based solution groups were 3.5, 4.0, and 4.5, respectively. This difference was statistically significant (p < 0.05). Patient satisfaction was also evaluated, and the chlorhexidine gluconate group reported higher satisfaction rates compared to the other groups. The satisfaction rate in the chlorhexidine gluconate group was 90%, while the rates in the povidone-iodine, iodophor, and alcohol-based solution groups were 80%, 75%, and 70%, respectively. This difference was statistically significant (p < 0.05). In conclusion, the randomized trial comparing skin antiseptic agents at cesarean delivery demonstrated that chlorhexidine gluconate is an effective antiseptic agent for reducing the incidence of SSIs, shortening hospital stay, and improving patient satisfaction. These findings suggest that chlorhexidine gluconate should be considered as the preferred antiseptic agent for cesarean deliveries to enhance patient outcomes and reduce healthcare costs associated with SSIs. Further research is needed to explore the long-term effects of chlorhexidine gluconate and to determine the optimal dosing and application methods for this antiseptic agent.
