The Efficacy of Subcutaneous Swabbing of Cesarean Section Wounds with Povidone Iodine to Prevent Post-Operative Wound Infection: A Randomized Controlled Study

Abstract
Background: Cesarean delivery is one of the most common surgical procedures performed by obstetricians. Infectious morbidity after cesarean delivery can have a tremendous impact on the postpartum woman's return to normal function and her ability to care for her baby. Despite the widespread use of prophylactic antibiotics, post-operative infectious morbidity still complicates cesarean deliveries [1]. Wound irrigation with povidone-iodine, an antiseptic solution, may be useful for reducing infection, but it is of uncertain efficacy and risk. Povidone-iodine irrigation is a simple and inexpensive solution with the potential to prevent surgical site infection [2].
Patients and Methods: This study was a randomized controlled prospective study in Assiut University Women's Health Hospital on women undergoing cesarean delivery in the period from November 2015 to September 2016. Study group (Group A) the subcutaneous tissue was swabbed with 10cc of undiluted 10% povidone iodine and was not mobbed. Group B; no swabbing.
Aim of Study: To assess the efficacy of subcutaneous swabbing of cesarean section wounds with povidone iodine to prevent post-operative wound infection.
Results: In our study, there was no statistically significant difference in personal and clinical history as regarding age, education, residence, urgency of cesarean section, presence of labor, gravidity, number of abortion but there was a statistical difference between the study groups in number of living children and number of previous cesarean section. There was no statistically significant difference in clinical examination as regarding BP, temperature, gestational age, presentation, presence of tender scar and rupture of membranes. There was a statistical difference between the study groups in pulse. There was a statistical difference between the study groups in investigations as regarding WBCs, estimated fetal weight and amniotic fluid index but there was a statistical difference in HB and platlets. There was no statistically significant difference in the operative data as regarding visceral and parietal peritoneal closure and duration of the procedure but there was a statistical difference in the level of the surgeon. There was no statistical difference between the study groups in presence of post-operative infection.
Conclusion: There was no benefit of subcutaneous tissue swabbing with povidone iodine in decreasing wound infection following cesarean section.