Yoshida Tsukasa, Akitani Fumi, Hayashi Kuniyoshi, Shioda Kyoko
Department of Obstetrics and Gynecology, St. Luke's International Hospital, Tokyo, Japan.
Clinical Epidemiology HTA Center, St. Luke's University, Tokyo, Japan.
J Obstet Gynaecol Res. 2021 Mar;47(3):935-940. doi: 10.1111/jog.14615. Epub 2020 Dec 16.
To investigate the effectiveness of 10% povidone-iodine formulation as a vaginal irrigation agent in patients undergoing hysterectomy to prevent postoperative infection.
The prevalence of postoperative infection in 277 and 132 patients who underwent preoperative vaginal cleaning with 500 mL of distilled water and 20 mL of 10% povidone-iodine solution, respectively, were compared in this retrospective study.
Postoperative infection was observed in 15.6% of the overall patient population. The rate of postoperative infection was significantly higher in patients treated with 10% povidone-iodine formulation than in those treated with distilled water (21.4% vs 12.8%, P = 0.040). Besides the agents of vaginal irrigation, operation time, length of hospital stay and rate of intraoperative complications affected the prevalence of postoperative infection. The multivariate analysis ranked the use of 10% povidone-iodine formulation for vaginal irrigation as the second top factor contributing to postoperative infection (relative risk: 1.9 when compared to distilled water).
Preoperative vaginal irrigation with 10% povidone-iodine formulation led to a significantly higher rate of postoperative infection than did preoperative vaginal irrigation with distilled water. For vaginal irrigation with povidone-iodine, different concentrations and cleaning methods should be considered in the future.
探讨10%聚维酮碘制剂作为阴道灌洗剂在子宫切除患者中预防术后感染的有效性。
在这项回顾性研究中,比较了分别用500毫升蒸馏水和20毫升10%聚维酮碘溶液进行术前阴道清洁的277例和132例患者的术后感染发生率。
在所有患者中观察到术后感染率为15.6%。使用10%聚维酮碘制剂治疗的患者术后感染率显著高于用蒸馏水治疗的患者(21.4%对12.8%,P = 0.040)。除了阴道灌洗剂外,手术时间、住院时间和术中并发症发生率也影响术后感染的发生率。多因素分析将使用10%聚维酮碘制剂进行阴道灌洗列为导致术后感染的第二大因素(与蒸馏水相比,相对风险:1.9)。
术前用10%聚维酮碘制剂进行阴道灌洗导致的术后感染率显著高于术前用蒸馏水进行阴道灌洗。未来对于聚维酮碘阴道灌洗,应考虑不同的浓度和清洁方法。