Povidone-iodine gel vaginal antisepsis for abdominal hysterectomy

OBJECTIVE: Our goal was to assess the safety and effectiveness of vaginal povidone-iodine gel in reducing febrile morbidity after abdominal hysterectomy. STUDY DESIGN: This cohort study included 158 women treated with gel immediately before hysterectomy, after the usual surgical preparation, and 317 historic control subjects with the usual surgical preparation only, at two teaching hospitals. Febrile morbidity was assessed by a blinded review of temperature records and was analyzed by Fisher's exact test and multiple logistic regression. RESULTS: Febrile morbidity occurred in 17% of gel-treated patients and 26% of controls (adjusted odds ratio 0.52, 95% confidence interval 0.31 to 0.89). In patients receiving prophylactic antibiotics the adjusted odds ratio for febrile morbidity in gel-treated patients was 0.47 (95% confidence interval 0.27 to 0.83). Prolonged fever occurred in 17% of controls and 10% of gel-treated patients (adjusted odds ratio 0.52, 95% confidence interval 0.28 to 0.97). CONCLUSION: Preoperative vaginal povidone-iodine gel is a safe and promising technique for reducing febrile morbidity after hysterectomy.