Effectiveness of Vaginal Douching on Febrile and Infec tious Morbidities after Total Abdominal Hysterectomy : A Multicenter Randomized Controlled Trial
PRANOM BUPPASIRI, MD*, CHOMPILAS CHONGSOMCHAI, MD, MHS*, NAREERAK WONGPROAMAS, BSc*, JANYAPORN OUNCHAI, MD** , BUNPODE SUWANNACHAT, MD*** PISAKE LUMBIGANON, MD, MS*
Affiliation : * Departments of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, ** Khon Kaen Regional Hospital, Khon Kaen 4()()()(), *** Kalasin General Hospital, Kalasin 46000, Thailand.
Objective : To evaluate the effectiveness of vaginal douching with I per cent povidone-iodine in reducing febrile and infectious morbidities after total abdominal hysterectomy (TA H).
Method : The authors conducted a randomized controlled trial in 300 patients undergoing elective TAH in three hospitals in Northeast Thailand: a university, a regional and a general hospital. The patients were randomly allocated to the intervention or control groups. Patients in the intervention group received pre-operative vaginal douching with I per cent povidone-iodine while patients in the control group did not. External evaluators not apprised of the intervention assessed febrile and infec tious morbidities.
Results : 300 patients were enrolled in the study. The incidences of febrile morbidity in patients with and without pre-operative vaginal douching were 25 and 35 per cent, respectively, though not statistically significant (risk difference -9.6%, 95% CI -19.9%, 0.8%, adjusted odds ratio 0.6, 95% CI 0.3%, 1.0%). A statistically significant difference in infectious morbidity was found between the groups (8 vs 19%, risk difference -10.0%,95% CI -17.8%, -2.2%, adjusted odds ratio 0.4, 95% CI 0.2%, 0.9%).
Conclusion : Pre-operative vaginal douching with I per cent povidone-iodine significantly reduces infectious morbidities after T AH.
Keywords : Total Abdominal Hysterectomy, Vaginal Douching
