In young patients, postoperative surgical site infections (SSIs) are frequent and sometimes life-threatening complications. Preparing the skin for surgery is a standard precaution before any incision. Chlorhexidine gluconate and iodophors in alcohol-based solutions are the most often used antiseptic agents for surgical skin preparation. Chlorhexidine-containing antiseptic treatments have been recommended for adult patients before surgery to lower the incidence of surgical site infections. The purpose of this study was to systematically review the literature on antiseptic agents used for surgical skin preparation in children younger than 16 years of age. MeSH and free text phrases were used in a systematic search of MEDLINE, EMBASE, CINAHL, and CENTRAL, and the appropriate Cochrane filter was applied to retrieve full-text articles of randomized trials (RCTs) and comparative observational studies. Antiseptic solutions containing chlorhexidine, povidone-iodine, or alcohol were the interventions of interest since they could be compared to one another or other antiseptics. Reports of infection at the surgery site were the primary measure of success. A total of 8 studies were included in the meta-analysis; 2 randomized controlled trials and 6 observational studies. The correlation between different antiseptics and subsequent SSI was not a primary focus of observational investigations. There were only 61 kids included in the identified RCTs, making them small and of low quality. As a result, researchers refrained from performing a proper meta-analysis. No randomized controlled trials evaluating antiseptic agents for surgical skin preparation in pediatric surgery have been completed since the release of a thorough systematic review of perioperative treatments for the prevention of SSI in 2016. The best skin antisepsis to decrease SSIs in children is unknown. Extrapolating adult trial results to children is inappropriate because of differences in physiology and SSI risk factors. High-quality RCTs are needed to determine the best ways to reduce SSI in children.
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