Preoperative Vaginal Preparation and Infection After Gynecologic Surgery

Area of Science:

• Gynecology
• Surgical Infection Prevention
• Antiseptic Efficacy

Background:

• Surgical site infections (SSI) are a significant concern following gynecologic surgery.
• Optimal preoperative vaginal antiseptic protocols to minimize SSI risk remain incompletely defined in current literature.

Purpose of the Study:

• To evaluate the association between chlorhexidine vaginal preparation and the incidence of postoperative surgical site infection (SSI) in gynecologic surgery.
• To compare the rate of chlorhexidine vaginal preparation use in patients with and without postoperative SSI.

Main Methods:

• Retrospective case-control study of women undergoing gynecologic surgery from 2010-2023.
• Cases (n=101) with postoperative SSI were matched 1:4 to controls (n=404) without SSI.
• Multivariable logistic regression analysis was employed to identify factors associated with SSI.

Main Results:

• Chlorhexidine vaginal preparation was used less frequently in SSI cases (11%) compared to controls (26%).
• Chlorhexidine vaginal preparation was significantly associated with a reduced odds of SSI (adjusted odds ratio, 0.4).
• Patients receiving chlorhexidine had lower rates of non-SSI postoperative complications, readmission, and reoperation.

Conclusions:

• Preoperative vaginal chlorhexidine preparation is associated with a substantial reduction in SSI risk within 30 days of gynecologic surgery.
• The findings support the use of chlorhexidine as an effective antiseptic agent for reducing SSI in gynecologic procedures.