Effect of vaginal cleansing on postoperative factors in elective caesarean sections: a prospective, randomised controlled trial

Abstract

Objective: To assess the effect of povidone iodine versus benzalkonium chloride, which were applied preoperatively for vaginal disinfection in caesarean sections, on postoperative factors.

Methods: One hundred and twenty patients underwent elective caesarean section were divided into three groups using the simple randomisation method: Group 1 (povidone iodine, n: 41); Group 2 (benzalkonium chloride, n: 39); Group 3 (control group, n: 40). Demographic data, duration of operation, amount of bleeding, postoperative pain, time to first flatulence and defaecation, haematological parameters on postoperative day 1 were compared between three groups. Pain evaluation was performed at 6th and 24th postoperative hour using Visual Analogue Scale.

Results: No statistically significant differences were detected between the groups in demographic characteristics. There were no significant differences between the groups with respect to the duration of operation and hospital stay. The patients in the group who underwent povidone iodine vaginal cleansing had statistically significantly less postoperative pain as compared to control group. No difference was observed between the groups in haematological parameters other than C-reactive protein (CRP); however, CRP levels at 24th post-operative hour were significantly lower in Group 1 compared to the other groups.

Conclusions: The preoperative vaginal cleansing with povidone iodine could reduce the postoperative pain, analgesic need and infection parameter.

Keywords: Benzalkonium chloride; caesarean section; povidone iodine; prophylaxis; wound site infection.