Randomized Controlled Trial Evaluating the Efficacy and Cost Effectiveness of a Ready-to-Use Applicator Containing Iodine Povacrylex and Isopropyl Alcohol Compared with Conventional Skin Scrubbing and Painting in Patients Undergoing Colorectal Surgery

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Pariyada Tanjak
Benjarat Thiengtrong
Darin Lohsiriwat
Varut Lohsiriwat
Amorn Leelaratsamee
Vitoon Chinswangwatanakul

Abstract

Objective: The aim of this study was to evaluate the efficacy and cost-effectiveness of a ready-to-use applicator containing iodine povacrylex and isopropyl alcohol (IPIA) for the prevention of surgical site infection (SSI) following intra-abdominal surgery.
Materials and Methods: The IPIA was randomly used in patients who underwent colorectal surgical procedures. The control group for comparison was a group of patients who underwent colorectal surgical procedures using conventional skin scrubbing and painting with antiseptic solutions without IPIA. In total, 100 patients were included in the study, randomized into 2 groups: one was applied IPIA and another group a conventional skin preparation. The outcome measurements included ease-of-use as assessed by a questionnaire, preparation time comparison, estimated skin preparation expense, adverse reactions, and rate of SSI. All the patients were visited daily up to 7 days postoperation or until discharge, and then 14 and 30 days postoperatively for monitoring the occurrence of SSI.
Results: Of the 100 patients undergoing elective intra-abdominal surgery enrolled in the study, 51 were males and 49 females, with the mean age of 63.5 ± 11.3 years. The majority of the patients had undergone colorectal cancer colectomies or rectal resections. There was no mortality. Seven patients (7%) had postoperative SSI (4 patients in the control group and 3 patients in the IPIA group, 4% vs. 3%, p = 0.45). The bacterial cultures revealed Gram negative-bacilli in all of the patients with SSI. The preparation time for the skin preparation was 5.48 ± 2.49 min in the control group and 2.65 ± 1.55 min in the IPIA group (p = 0.002), without statistical significance of expenses.
Conclusion: IPIA was demonstrated to be as safe and effective as conventional antiseptic solutions as a skin preparation to prevent SSI following colorectal surgery. With good ease of use, IPIA proved more convenient than a scrubbing preparation as well as offered better cost effectiveness by significantly reducing the time and cost of the skin preparation.

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Tanjak, P. ., Thiengtrong, B. ., Lohsiriwat, D. ., Lohsiriwat, V. ., Leelaratsamee, A. ., & Chinswangwatanakul, V. . (2021). Randomized Controlled Trial Evaluating the Efficacy and Cost Effectiveness of a Ready-to-Use Applicator Containing Iodine Povacrylex and Isopropyl Alcohol Compared with Conventional Skin Scrubbing and Painting in Patients Undergoing Colorectal Surgery. Siriraj Medical Journal, 73(9), 570–575. https://doi.org/10.33192/Smj.2021.74
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Original Article

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