A study showing effectiveness of surgical site skin preparation, with two step use of povidone-iodine and postoperative out come in orthopaedic patients

Background: The most common cause or source of infection in operating room is bacteria coming from inadequate cleaning of skin, surrounding environment, from the staff and from patient itself; especially geriatric with low immunity and diabetic patients. Surgical site skin infection complicates an estimated 5% of all surgeries performed in operation theater. Every measure must be taken to reduce the surgical site infection henceforth reducing the cost of treatment and morbidity of the patient. Povidone-iodine seems to be the best and cheap option.Methods: One hundred and forty two patients who underwent orthopaedic surgery has been studied for the postoperative outcome following pre-surgical skin preparation with 2 step use of povidone iodine (PVP-I). The area to be operated is scrubbed with PVP-I scrub 7.5% and then painted with 10% PVP-I solution on operative area and wide area above and below. The paint is kept for at least 10 min or till it dry and then washed with normal saline or cleaned with sterile gauze soaked in normal saline. All postoperative patients were given intravenous antibiotics for at least 3 days. Dressing was done with PVP-I as per protocol.Results: It has been found that out of one hundred and forty two patients studied, only 3.52% developed infection. Out of five infected patients, two were female and three with fracture were male patients.Conclusions: PVP-I is still one of the best anti-microbial preparation widely used in orthopaedic surgery till date. It has broad spectrum anti-microbial activity and do not have any history of developing any resistance to its content