EFFECT OF POVIDONE-IODINE IRRIGATION ON POST APPENDECTOMY WOUND INFECTION: RANDOMIZED CONTROL TRIAL

Objective: Despite the use of prophylactic antibiotics and sterilization techniques, rate of post appendicectomy wound infection is high. The usefulness of povidone-iodine on intact skin is well-established but its use as prophylactic irrigation solution on open surgical wounds is limitedly addressed. This study compare the frequency of superficial surgical site infection after appendicectomy, with and without peroperative irrigation of subcutaneous tissue with 1% povidone-iodine solution. Methods: A Total of 166 patients operated for acute appendicitis with open appendicectomy at Civil Hospital Karachi were included in the study. They were randomly allocated into two groups. In the treatment group, the subcutaneous tissue was irrigated with 1% diluted povidone-iodine solution before skin closure while no irrigation was done in the control group. All patients were followed for surgical site infection according to Southampton wound grading system for 30 days after surgery. Results: The mean age of patients was 25.96±9.9 years with a male to female ratio of 2:1. Wound healed normally with no signs of inflammation in 107 (64.5%) out of 166 patients. Mild bruising was present in 34(20.5%), erythema with tenderness or heat in 11(6.6%) and serous/ haemoserous discharge in 6(3.6%) patients with no significant difference between the groups. Purulent discharge was significantly reduced in the treatment group (p-value<0.05). The overall infection rate was 10.8% and 19.3% in the treatment and control group respectively (p=0.129). Conclusion: The irrigation of the subcutaneous tissue with 1% diluted povidone- iodine solution after appendicectomy, though not affect the overall infection rate but significantly reduced the formation of pus within the infected wound cavity