Perbandingan Preparasi Kulit Menggunakan Alkohol-Klorheksidin dengan Alkohol-Povidon Iodin terhadap Infeksi Luka Operasi Seksio Sesarea

https://doi.org/10.22146/jkr.35416

Moh. Nailul Fahmi(1*), Diah Rumekti Hadiati(2), Shofwal Widad(3)

(1) Departement of Obstetrics and Gynecology, Faculty of Medicine, University of Gadjah Mada
(2) 
(3) 
(*) Corresponding Author

Abstract


Background: Surgical site infection (SSI) is the second most frequent nosocomial infection and has high morbidity and mortality rate. The use of preoperative skin antiseptics effective in preventing of surgical site infection. There are lack of evidences to evaluate types, concentration and application methods of antiseptic for skin preparation for preventing infection following caesarean section

Objective: to determine the difference of SSI rate in patients receiving alcohol-chlorhexidine and alcoholpovidone iodine as an agent for skin preparation during caesarean section. Method: The study design was randomized clinical trial. The study was conducted in Dr Sardjito hospital and two affiliated hospital (Saras Husada Hospital and Panembahan Senopati Hospital). Total 174 subjects meeting in inclusion and exclusion criteria were divided into two groups. Experimental group (87 subjects) received alcohol-chlorhexidine as skin preparation antiseptic during caesarean section. Control group (87 subjects) received alcohol-povidone iodine. A computer generated random number was created to assigned subject into experimental and control goups. Outcome assessment was performed on day 3 and day 7 after caesarean section. Surgical site infection was diagnosed based on Center for Disease Control and Prevention (CDC) criteria.

Result and Discussion: There were no differences in terms of age, weeks of gestation, body mass index, parity, emergency/elective, duration of operation, duration of membrane rupture, and number of vaginal examination between two groups (P>0.05). SSI rates on day 3 were similar between two groups, alcoholchlorhexidine group was 13.8% (12 subjects) and alcohol-povidone iodine group was 11.5% (10 subjects). Cumulative SSI for 7 days were similar (p=1) between two group, alcohol-chlorhexidine group was 13.8% (12 subjects) and alcohol-povidone iodine group was 12.6% (11 subjects). Conclusions: there were no differences of SSI rates in patients receiving alcohol-chlorhexidine and alcoholpovidone iodine as an agent for skin preparation during caesarean section.

Keywords: Surgical site infections, skin preparation, alcohol, povidone iodine, chlorhexidine, caesarean section.


Keywords


Surgical site infections; skin preparat; n, alcohol; povidone iodine; chlorhexidine; caesarean section.



References

Anderson DJ. 2008. Strategies to Prevent Surgical Site Infection in Acute Care Hospitals. Infection Control and Hospital Control Epidemiology. Vol. 29, Suppl. 1.

Rauk PN. 2008. Chlorhexidine gluconate preoperative skin preparation initiated a 100% reduction of incisional Cesarean section infections while other risk factors were evaluated and corrected. APIC Annual Conference. June 15-19.

Centers for Disease Control and Prevention. Procedure-associated event surgical site infections. Infection Control and Hospital Epidemiology. 2012.

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom KD. 2005. Puerperal infection. Williams Obstetrics, 22nd Edition. New York: McGraw-Hill.

Ibrahim WH, Makhlouf AM, Khamis MA, and Youness EM. 2011. Effect of prophylactic antibiotics (Cephalosporin versus Amoxicillin) on preventing post caesarean section infection. Journal of American Science. 7(5).

Micah LH, Herbert L. 2009. Skin Preparation for the Prevention of Surgical Site Infection: Which Agent Is Best?. Reviews in Urology. Vol 11 No. 4.

Edwards P, Lipp A, Holmes A. 2009. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database of Systematic Reviews. Issue 3.

National Institute of Health and Clinical Excellence. Clinical Guideline: Prevention and treatment of surgical site infection. NICE Guideline. 2008.

Hadiati DR, Hakimi M, Nurdiati DS. Ota E. 2014. Skin preparation for preventing infection following caesarean section: Cochrane systematic review (Review), The Cochrane Library, Issue 9.

Darouiche RO, Wall MJ, Itani, Otterson MF, Webb, AL, Carrick, Miller, Awad, Crosby, Mosier, AlSharif, and Berger. 2010. Chlorhexidine–Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis. N Engl J Med. 362: 18-26.

Noorani A, Rabey N, Walsh SR, Davies RJ. 2010. Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery. Br J Surg; Nov; 97(11):1614-20.

Menderes G, Athar AN, Aagaard K, Haghpeykar H. 2012. Chlorhexidine-alcohol compared with povidone-iodine for surgical-site antisepsis in cesarean deliveries. Obstet Gynecol. Nov; 120(5):1037-44.

Demisew A, Tefera B, Fitsum A. 2011. Surgical site infection rate and risk factors among obstetric cases of Jimma University specialized hospital southwest Ethiopia. Ethiop J Health Sci; July Vol. 21, No. 2.



DOI: https://doi.org/10.22146/jkr.35416

Article Metrics

Abstract views : 2338 | views : 2887

Refbacks

  • There are currently no refbacks.


Copyright (c) 2017 Jurnal Kesehatan Reproduksi



Jurnal Kesehatan Reproduksi Indexed by:

 

 



SEKRETARIAT JURNAL KESEHATAN REPRODUKSI
Departemen Obstetri dan Ginekologi, FK-KMK, UGM/RS Dr. Sardjito
Jl. Kesehatan No. 1, Sekip Utara, Yogyakarta 55281
Tlp: (0274) 511329 / Faks: (0274) 544003
Email: jurnal.kesehatanreproduksi@ugm.ac.id
Cp: Dwi Astuti +6281802698043