Vaginal Preparation Prior to Hysterectomy

Phase 4

Terminated

Conditions: Hysterectomy

Interventions: Drug: Chlorhexidine
Drug: Iodine

Registration Number: NCT03412734

Lead Sponsor: TriHealth Inc.

Brief Summary: This is a randomized controlled trial to determine the influence of chlorhexidine gluconate surgical/topical antiseptic solutions on the bacterial environment of the vagina during hysterectomy and compare that to the effect of standard iodine-based preparations on the same.

Detailed Description: Postoperative infection remains the most common complication of surgical procedures in gynecology. Historically, 30-40% of patients undergoing a hysterectomy develop a post-operative infection. The initiation of antibiotic prophylaxis for appropriate surgical procedures was a significant advancement in the prevention of surgical site infection.

Antibiotic prophylaxis has been standardized and universally implemented. A remaining variable is the method of aseptic preparation of the vagina with substantial variation of technique being reported even within institutions.

The most recent Committee Opinion by the American College of Obstetricians and Gynecologists concludes there is insufficient evidence to render a strong recommendation for either povidone-iodine or chlorhexidine as the ideal agent for surgical preparation of the vagina and that further evidence is necessary.

Povidone-iodine solution has been considered the standard for aseptic surgical preparation of the vagina for decades and is the only solution approved by the FDA for vaginal use. There are however specific qualities of the solution that suggest it may be less than ideal for use in the vagina. More contemporary efforts have begun to focus on chlorhexidine as a more ideal agent for aseptic efforts in surgical preparation of the vagina.

The purpose of our study is to use a randomized controlled trial to determine if chlorhexidine gluconate surgical preparation maintains a lower rate of contamination to the surgical field.

Recruitment & Eligibility

Status: TERMINATED

Sex: Female

Target Recruitment: 94

Inclusion Criteria

Undergoing total vaginal, laparoscopic assisted vaginal, total laparoscopic, or robotic-assisted laparoscopic hysterectomy by a physician at Cincinnati Urogynecology Associates or Tri-State Gynecology Oncology TriHealth Inc.
Concomitant procedures such as vaginal vault suspension, suburethral sling, cystoscopy, enterocele repair, anterior or posterior colporrhaphy, bilateral salpingectomy or salpingooophorectomy, staging procedures, lymph node sampling and other indicated procedures will be included
English speaking
Ability to provide consent

Exclusion Criteria

Unwillingness to participate in the study
Non English speaking
Patients that do not undergo a hysterectomy
Reported allergy to iodine or chlorhexidine preparation solutions
Patients undergoing planned debulking surgery for ovarian, fallopian tube or primary peritoneal cancers
Current infection necessitating hysterectomy
Active sepsis, pelvic abscess or pelvic inflammatory disease