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Despite the clear importance of skin disinfection in preventing surgical-site infections (SSIs), surprisingly few comparative clinical trials have been conducted on the effectiveness of different antiseptic products. North American investigators now report a multicenter cluster-randomized crossover trial comparing the effectiveness of the two most common skin antiseptics, iodine povacrylex-alcohol (Duraprep) and chlorhexidine gluconate-alcohol (Chloraprep), in preventing SSI after fixation of closed (lower extremity or pelvic) fractures or open (upper or lower extremity) fractures.
Among 6785 patients with closed fracture fixation, incidence of SSIs was significantly lower with iodine than chlorhexidine (2.4% vs. 3.3%; P=0.049). In contrast,…