Intraoperative Disinfection by Pulse Irrigation withPovidone-Iodine Solution in Spine Surgery

Deep wound infection in spine surgery is a debilitating complication for patients and increases costs. The objective ofthis prospective study was to evaluate the efficacy of wound pulse irrigation with a dilute povidone-iodine solution in the preventionof surgical site infection.Methods. 50 patients undergoing spinal surgery were randomly divided into two groups (A and B) of 25patients each. In group A, wounds were irrigated with dilute (3%) povidone-iodine solution through a low-pressure pulsatile device.In group B, wounds were irrigated with saline solution through a bulb syringe. In both groups, specimens for bacterial culturewere harvested from surgical site before and after irrigation.Results. In group A, no surgical site infection occurred; in group B,deep wound infection was observed in 3 patients. In both groups, before irrigation some cultures have been found positive forbacterial contamination.Conclusion. Our study seems to support the idea that low-pressure pulsating lavage of surgical woundswith povidone-iodine diluted to a nontoxic concentration of 3% is an effective therapeutic adjunct measure to prevent surgicalsite infection in spine surgery. However, the number of the enrolled patients is small and a significant statistical analysis is notpracticable. This trial is registered with NCT03249363