Table 2.
Summary of Effects Table.
|
Patients or Population: Patients undergoing surgery Settings: Hospital Intervention: Alcohol-based chlorhexidine surgical site skin preparation Comparison: Alcohol-based iodophor surgical site skin preparation | |||||
| Outcomes | Absolute Effect | Absolute Risk Difference | Relative Effect * (95% CI) | Participants (Studies) | |
| Chlorhexidine-Alcohol | Iodophor-Alcohol | ||||
| All procedures | |||||
| All SSI | 216/3026 (7.1%) | 271/2997 (9.0%) | There were 19 more SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.790 (0.669 to 0.932) |
6023 (13 studies) |
| Superficial SSI | 105/2573 (4.1%) | 132/2584 (5.1%) | There were 10 more superficial SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.807 (0.632 to 1.032) |
5157 (12 studies) |
| Deep or Organ Space SSI | 67/2573 (2.6%) | 79/2584 (3.1%) | There were 5 more deep or organ space SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.904 (0.664 to 1.230) |
5157 (12 studies) |
| Adverse events | 2/1354 (0.15%) | 4/1361 (0.29%) | There is 1 more adverse event per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.603 (0.145 to 2.517) |
2715 (3 studies) |
| Bone and Joint Surgery | |||||
| All SSI | 14/555 (2.5%) | 4/555 (0.7%) | There were 18 more SSIs per 1000 participants with chlorhexidine-alcohol surgical site skin preparation compared with iodophor-alcohol | RR 2.667 (1.051 to 6.765) |
1110 (5 studies) |
| Superficial SSI | 7/555 (1.3%) | 3/555 (0.5%) | There were 8 more superficial SSIs per 1000 participants with chlorhexidine-alcohol surgical site skin preparation compared with iodophor-alcohol | RR 1.800 (0.607 to 5.335) |
1110 (5 studies) |
| Deep or Organ Space SSI | 7/555 (1.3%) | 2/555 (0.4%) | There were 9 more deep or organ space SSIs per 1000 participants with chlorhexidine-alcohol surgical site skin preparation compared with iodophor-alcohol | RR 2.250 (0.697 to 7.266) |
1110 (5 studies) |
| Adverse events | 0/390 (0.0%) | 0/390 (0.0%) | There were no events reported | RR 1.000 (0.020 to 50.271) |
1110 (5 studies) |
| Caesarean Surgery | |||||
| All SSI | 63/1319 (4.8%) | 104/1325 (7.8%) | There were 30 more SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.614 (0.453 to 0.831) |
2644 (3 studies) |
| Superficial SSI | 47/1319 (3.6%) | 73/1325 (5.5%) | There were 19 more superficial SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.653 (0.456 to 0.934) |
2644 (3 studies) |
| Deep or Organ Space SSI | 16/1319 (1.2%) | 31/1325 (2.3%) | There were 11 more deep or organ space SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.522 (0.287 to 0.952) |
2644 (3 studies) |
| Adverse events | 2/572 (0.3%) | 4/575 (0.7%) | There are 4 more adverse events per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.503 (0.092 to 2.733) |
1147 (1 study) |
| General surgery (including colorectal and abdominal) | |||||
| All SSI | 137/948 (14.5%) | 158/911 (17.3%) | There were 28 more SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.844 (0.686 to 1.038) |
1859 (3 studies) |
| Superficial SSI | 49/495 (9.9%) | 51/498 (10.2%) | There were 3 more superficial SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.968 (0.667 to 1.404) |
993 (2 studies) |
| Deep or Organ Space SSI | 44/495 (8.9%) | 46/498 (9.2%) | There were 3 more deep or organ space SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.965 (0.653 to 1.427) |
993 (2 studies) |
| Adverse events | 0/392 (0.0%) | 0/396 (0.0%) | There were no events reported | RR 1.010 (0.020 to 50.784) |
788 (1 study) |
| Skin and Soft Tissue Surgery | |||||
| All SSI | 2/204 (1.0%) | 5/206 (2.4%) | There were 14 more SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.460 (0.105 to 2.024) |
410 (2 studies) |
| Superficial SSI | 2/204 (1.0%) | 5/206 (2.4%) | There were 14 more superficial SSIs per 1000 participants with iodophor-alcohol surgical site skin preparation compared with chlorhexidine-alcohol | RR 0.460 (0.105 to 2.024) |
410 (2 studies) |
| Deep or Organ Space SSI | 0/204 (0.0%) | 0/206 (0.0%) | There were no events reported | RR 1.012 (0.064 to 16.072) |
410 (2 studies) |
| Adverse events | Not reported | Not reported | Not reported | Not estimable | No studies |
95% CI: 95% Confidence interval; RR: Risk ratio. * Risk Ratio included continuity correction.