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Impact of 1.5% Aqueous Olanexidine Against Surgical-Site Infections in Neurosurgery

Masahiro Uchimura1,2, Fusao Ikawa2,3,4, Toshikazu Hidaka3

  • 1Department of Neurosurgery, NHO Hamada Medical Center, Hamada , Shimane , Japan.

Operative Neurosurgery (Hagerstown, Md.)
|November 7, 2025
PubMed
Abstract

Insights

1.5% aqueous olanexidine may reduce surgical-site infections (SSIs) in neurosurgery compared to povidone-iodine. This study identified cerebrospinal fluid leakage and longer operation times as key risk factors for SSIs.

Area of Science:

  • Neurosurgery
  • Infectious Disease Prevention
  • Antiseptic Efficacy

Background:

  • Surgical-site infections (SSIs) are common postoperative complications.
  • Povidone-iodine and chlorhexidine-alcohol are traditional antiseptics for SSIs.
  • 1.5% aqueous olanexidine shows higher bactericidal potency than 10% povidone-iodine in gastrointestinal surgery.

Purpose of the Study:

  • Evaluate the efficacy of 1.5% aqueous olanexidine versus 10% povidone-iodine in neurosurgery.
  • Identify risk factors associated with SSIs in contemporary neurosurgery.

Main Methods:

  • Retrospective analysis of 1393 neurosurgery cases (2016-2022).
  • Categorization of SSIs into wound infection/epidural abscess and meningitis/brain abscess.
  • Examination of associations between SSIs and variables including antiseptic use, CSF leakage, and operation time.

Main Results:

  • Overall SSIs incidence was 3.8% (3.1% with olanexidine vs. 5.8% with povidone-iodine, P=.024).
  • 1.5% aqueous olanexidine use was inversely associated with all SSIs (aOR=0.53).
  • Cerebrospinal fluid leakage, shunt placement, CSF drainage, cranioplasty, and longer operation times were significant risk factors for SSIs.

Conclusions:

  • 1.5% aqueous olanexidine may help prevent SSIs in neurosurgical procedures.
  • Cerebrospinal fluid leakage is a major risk factor for both wound infection/epidural abscess and meningitis/brain abscess.
Keywords:
Aqueous olanexidineNeurosurgerySurgical-site infection

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