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Marchionatti et al: Preoperative skin asepsis protocols using chlorhexidine versus povidone‐iodine in veterinary surgery: A systematic review and meta-analysis
Veterinary Surgery 5, 2022

🔍 Key Findings

  • Chlorhexidine-based asepsis protocols were comparable to povidone-iodine for reducing surgical site infection (SSI) rates in veterinary surgery.
  • No significant difference in skin bacterial colonization was observed between the two antiseptics, at both immediate and delayed timepoints.
  • Chlorhexidine-alcohol protocols showed a non-significant trend toward improved bacterial reduction in some studies, though inconsistent across all studies.
  • Use of neutralizing agents was inconsistent, which may have led to overestimation of antiseptic efficacy in several studies.
  • Formulations and concentrations varied widely (e.g., chlorhexidine 0.5–4%, povidone-iodine 0.7–1%), contributing to heterogeneity and limiting definitive conclusions.
  • Only a minority of studies reported using CDC criteria for SSI diagnosis, affecting the reliability of infection outcomes.
  • Risk of bias was high or unclear in multiple domains across all included studies, limiting overall confidence in conclusions.
  • Meta-analysis confirmed no statistically significant superiority of either protocol for SSI prevention or skin bacterial reduction.

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← Articles

Marchionatti et al: Preoperative skin asepsis protocols using chlorhexidine versus povidone‐iodine in veterinary surgery: A systematic review and meta-analysis
Veterinary Surgery 5, 2022

🔍 Key Findings

  • Chlorhexidine-based asepsis protocols were comparable to povidone-iodine for reducing surgical site infection (SSI) rates in veterinary surgery.
  • No significant difference in skin bacterial colonization was observed between the two antiseptics, at both immediate and delayed timepoints.
  • Chlorhexidine-alcohol protocols showed a non-significant trend toward improved bacterial reduction in some studies, though inconsistent across all studies.
  • Use of neutralizing agents was inconsistent, which may have led to overestimation of antiseptic efficacy in several studies.
  • Formulations and concentrations varied widely (e.g., chlorhexidine 0.5–4%, povidone-iodine 0.7–1%), contributing to heterogeneity and limiting definitive conclusions.
  • Only a minority of studies reported using CDC criteria for SSI diagnosis, affecting the reliability of infection outcomes.
  • Risk of bias was high or unclear in multiple domains across all included studies, limiting overall confidence in conclusions.
  • Meta-analysis confirmed no statistically significant superiority of either protocol for SSI prevention or skin bacterial reduction.

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Multiple Choice Questions on this study

In Marchionatti 2022 et al., on antiseptic efficacy comparison, what was reported about skin bacterial colonization?

A. Chlorhexidine reduced colonization significantly more than povidone-iodine
B. Povidone-iodine showed better colonization control at delayed timepoints
C. Both antiseptics showed equivalent colonization reduction
D. Chlorhexidine had no effect on colonization but povidone-iodine did
E. Only povidone-iodine-alcohol combination was effective

Answer: Both antiseptics showed equivalent colonization reduction

Explanation: Meta-analysis demonstrated no significant difference in immediate or delayed colonization between groups (RR and SMD not significant):contentReference[oaicite:1]{index=1}
In Marchionatti 2022 et al., on antiseptic efficacy comparison, what was the finding of the meta-analysis regarding SSI incidence with chlorhexidine vs povidone-iodine protocols?

A. Chlorhexidine significantly reduced SSI incidence compared to povidone-iodine
B. Povidone-iodine significantly reduced SSI incidence compared to chlorhexidine
C. Chlorhexidine was associated with significantly increased SSI risk
D. There was no significant difference in SSI incidence between protocols
E. Chlorhexidine reduced SSI only when combined with alcohol

Answer: There was no significant difference in SSI incidence between protocols

Explanation: Meta-analysis showed no statistical difference in postoperative SSI between protocols (RR 0.90; P = 0.82):contentReference[oaicite:0]{index=0}
In Marchionatti 2022 et al., on antiseptic efficacy comparison, what issue may falsely elevate the observed efficacy of antiseptics in skin cultures?

A. Use of low antiseptic concentration
B. Poor patient compliance
C. Lack of neutralizing agents during sampling
D. Delayed application of antiseptics
E. Incorrect dilution technique

Answer: Lack of neutralizing agents during sampling

Explanation: Residual activity of antiseptics without neutralizers can persist after sampling, skewing results:contentReference[oaicite:3]{index=3}
In Marchionatti 2022 et al., on antiseptic efficacy comparison, what methodological limitation was common across studies?

A. Use of unlicensed antiseptics
B. High cost of protocols
C. Blinded outcome assessors
D. Unclear risk of bias due to insufficient reporting
E. Standardized alcohol concentration across groups

Answer: Unclear risk of bias due to insufficient reporting

Explanation: Most studies lacked detail in randomization and blinding methods, leading to unclear risk of bias in multiple domains:contentReference[oaicite:2]{index=2}
In Marchionatti 2022 et al., on antiseptic efficacy comparison, which of the following best reflects the conclusion?

A. Chlorhexidine is clearly superior and should replace povidone-iodine
B. Povidone-iodine should be preferred for all clean procedures
C. Chlorhexidine and povidone-iodine are both effective, with no clear superiority
D. Neither antiseptic is effective in small animal surgery
E. Chlorhexidine is effective only in orthopedic surgeries

Answer: Chlorhexidine and povidone-iodine are both effective, with no clear superiority

Explanation: The study concluded both protocols were comparable for SSI prevention and bacterial reduction:contentReference[oaicite:4]{index=4}

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