Preoperative vaginal preparations for abdominal hysterectomy for the prevention of febrile morbidity: savlon douching vs povidone-iodine painting.

OBJECTIVE: To compare the effectiveness between savlon solution was douching and povidone-iodine solution painting for reducing febrile morbidity after total abdominal hysterectomy. Study design: Clinical trial. MATERIAL AND METHOD: One hundred and fifty patients at Srinagarind Hospital were scheduled for total abdominal hysterectomy (TAH). All subjects were non-randomly allocated to receive either savlon (1:1000 solutions) douching or povidone-iodine (1% solution) painting as pre-operative vaginal preparations. They also received Cefazolin 1 gm. intravenously before the operation. The principal outcome of the study was febrile morbidity. RESULTS: The overall rate of febrile morbidity was 21 percent. The incidence of febrile morbidity in the savlon vs. povidone-iodine groups was 16 (12/75) and 25 (19/75) percent, respectively. No statistically significant difference was found between the two groups (p-value = 0.16). The odds ratio was 1.78 (95%CI 0.79 to 3.99) and adjusted odds ratio was 2.09(95%CI 0.86 to 5.10) CONCLUSION: The effectiveness between savlon solution douching and povidone-iodine solution painting in conjunction with a prophylactic antibiotic before TAH for reducing febrile morbidity was not significant different.

Effect of pre-operative skin preparation on post-operative wound infection.

A prospective randomised trial was carried out to compare the efficacy of method of scrubbing the operative site for ten minutes with an antiseptic (GpA; n = 68) with a simplified method where the antiseptic was merely painted onto the operation site (GpB; n = 67). The median age, sex distribution and the types of procedures done in each group were similar as was the antibiotic policy. There were a total of 11 patients who got infected, 6 in the group A and 5 in the group B. No significant difference could be demonstrated in the infection rates between the two groups. It is concluded that the old method of prolonged scrubbing the operation site can safely be omitted to a more simplified version.