Alternative Antiseptic Found Safer for C-Sections

Women were less likely to have an infection when their doctor used chlorhexidine-alcohol antiseptic instead of iodine-alcohol. It's worth discussing with your doc.

Alternative Antiseptic Found Safer for C-Sections

Headed in for a C-section? You may worry about getting an infection after your surgery, after all, in 2013, as many as 12 percent of the 1.3 million women in the U.S. who delivered babies via cesarean experienced post-surgical infections, according to a recent study in The New England Journal of Medicine. But now your chances could be even slimmer, thanks to a new discovery.

The NEJM study found that using a chlorhexidine-alcohol antiseptic after a C-section reduces your chances of getting an infection better than the commonly used iodine-alcohol.

Methodious G. Tuuli, M.D., lead author and assistant professor at the Washington University School of Medicine in St. Louis, said the evidence is so strong, it could make chlorhexidine-alcohol the standard antiseptic for all C-sections.

Strong evidence

Dr. Tuuli conducted a clinical trial of 1,147 patients who had C-sections at a single hospital from 2011 to 2015, splitting them into two groups: 572 had chlorhexidine-alcohol and 575 had iodine-alcohol. Other common practices to prevent infection, such as pre-surgery antibiotics, were administered to all women.

In total, 42 women in the iodine-alcohol group got infections within 30 days of the procedure (4%), while only 23 women in the chlorhexidine-alcohol group suffered the same fate (7.3%).

Dr. Tuuli said the superiority of the chlorhexidine-alcohol combination was consistent whether the C-section was scheduled or unscheduled, and regardless of whether the patient was obese, had staples or sutures or had chronic medical conditions, such as diabetes.

Improving C-sections

"C-section is so normal," Dr. Tuuli says. "It doesn't look like the rates are going down. If we are going to do them, we should do them well and reduce complications as much as possible."

Dr. Tuuli's research on sutures being superior to staples for closing a C-section has made it a preferred practice. Based on his latest research, he's hoping to see the same thing happen with chlorhexidine-alcohol.

"This is the type of study that should change practice ... Everything lines up," Dr. Tuuli says. "Chlorhexidine should really be the recommendation of choice."

Tuuli says women should talk to their doctors about which antiseptic they will use during their procedure. If you know you're allergic to chlorhexidine-alcohol—chlorhexidine is in some mouthwashes and antiseptics—your doctor should use iodine-alcohol.

Though the chlorhexidine-alcohol is four times as expensive as iodine-alcohol, the initial expenditure could help thwart an infection that costs an average of $3,500, according to Dr. Tuuli's research.

It's working in his hospital, where they only use a chlorhexidine-alcohol antiseptic. "We have changed our practice," Dr. Tuuli added. "Chlorhexidine-alcohol is the antiseptic of choice...period."

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