• Christodoulos Kaoutzanis, Crystal M Kavanagh, Stefan W Leichtle, Kathleen B Welch, AkkeNeel Talsma, James F Vandewarker, Richard M Lampman, and Robert K Cleary.
• 1 Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, Michigan 2 Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan 3 School of Medicine, University of Michigan, Ann Arbor, Michigan.
• Dis. Colon Rectum. 2015 Jun 1;58(6):588-96.

BackgroundSurgical site infections are a major cause of morbidity and mortality after colorectal operations. Preparation of the surgical site with antiseptic solutions is an essential part of wound infection prevention. To date, there is no universal consensus regarding which preparation is most efficacious.ObjectiveThis study compared 2.0% chlorhexidine with 70.0% isopropyl alcohol versus 0.7% iodine povacrylex with 74.0% isopropyl alcohol and alcohol-based versus nonalcohol-based skin preparations with regard to efficacy in preventing postoperative wound infections.DesignThis is a retrospective study from 2 prospectively collected statewide databases combined. A propensity score model was used to adjust for differences between the groups in patient demographics, characteristics, comorbidities, and laboratory values.SettingsThe multicenter data set used in this analysis represents a variety of academic and community hospitals within the state of Michigan from January 2010 through June 2012.PatientsPatients over the age of 18 years who underwent clean-contaminated colorectal operations were included.Main Outcome MeasuresThe incidence of superficial surgical site infections, any surgical site infection, any wound complication, and readmission within 30 days for surgical site infection were measured.ResultsWhen 2.0% chlorhexidine with 70.0% isopropyl alcohol (n = 425) and 0.7% iodine povacrylex with 74.0% isopropyl alcohol (n = 115) were compared, a total of 540 colorectal cases met inclusion criteria. When alcohol-based (n = 610) and nonalcohol-based (n = 177) skin preparations were compared, a total of 787 colorectal cases met inclusion criteria. There was no significant difference in the propensity-adjusted odds for having any of the 4 outcomes of interest when comparing 2.0% chlorhexidine with 70.0% isopropyl alcohol to 0.7% iodine povacrylex with 74.0% isopropyl alcohol and when comparing alcohol-based with nonalcohol-based skin preparations.LimitationsThis was a nonrandomized study performed retrospectively based on data collected within the state of Michigan.ConclusionsThe use of 2.0% chlorhexidine with 70.0% isopropyl alcohol versus 0.7% iodine povacrylex with 74.0% isopropyl alcohol or alcohol-based versus nonalcohol-based skin preparations does not significantly influence the incidence of surgical site infections or readmission within 30 days for surgical site infection after clean-contaminated colorectal operations.

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