Evidence map›Paper›PMID 42558178›Full record

Trial reportClinics in orthopedic surgery2026

Comparison of Clinical Outcomes According to Preoperative Skin Preparation in Hip Arthroplasty for Hip Fracture: A 3-Arm Randomized Controlled Trial.

Chanhee Park, Seung-Cheol Choi, Seong Gyu Kim, Myung-Rae Cho, Suk-Kyoon Song

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Clinics in orthopedic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Chanhee ParkDepartment of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.ORCID https://orcid.org/0000-0003-1125-2476
Seung-Cheol ChoiDepartment of Orthopedic Surgery, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea.ORCID https://orcid.org/0000-0003-1920-6853
Seong Gyu KimDepartment of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea.ORCID https://orcid.org/0000-0001-7900-7560
Myung-Rae ChoDepartment of Orthopedic Surgery, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea.ORCID https://orcid.org/0000-0003-2901-9787
Suk-Kyoon SongDepartment of Orthopedic Surgery, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea.ORCID https://orcid.org/0000-0002-3241-5820

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Patients with hip fractures undergoing arthroplasty are typically old and frail, and superficial surgical site infections (SSIs) can delay mobilization and prolong hospitalization. Preoperative skin antisepsis is a low-cost, universally used intervention. However, clinical practice varies, and evidence from elective arthroplasty may not fully generalize to urgent hip fracture surgery. Sequential dual-antiseptic protocols combining povidone-iodine (PVI) and chlorhexidine gluconate (CHG) are increasingly adopted; however, the optimal order for "scrub" versus "paint" remains unclear. We compared the prophylactic efficacy of 3 skin preparation protocols using different sequences of PVI and CHG. Methods: In this single-center, prospective, randomized controlled trial, 108 patients undergoing hip arthroplasty for hip fracture were randomly allocated to 3 groups based on the antiseptic agents used for the mechanical "scrub" and final "paint" steps: group 1 (PVI scrub/PVI paint), group 2 (PVI scrub/CHG paint), and group 3 (CHG scrub/PVI paint). The primary outcome was the rate of positive skin culture results immediately before draping and pathogen identification results. The secondary outcome was the incidence of superficial SSI. Results: Post-preparation culture positivity was significantly lower in the CHG-containing groups (group 2 and group 3: 5.6% each) than in the PVI-only group (group 1: 27.8%; Conclusions: The sequence of antiseptic application significantly influenced microbiological outcomes, with CHG-containing protocols demonstrating lower post-preparation culture positivity. A protocol using a CHG scrub followed by PVI paint provided the most effective bacterial suppression. Differences in superficial SSI rates were also observed and may reflect the impact of improved microbiological control. Optimizing the order of antiseptic administration may contribute to improved infection prevention in this high-risk population.

Indexed as

Anti-Infective Agents, LocalArthroplasty, Replacement, HipHip FracturesPreoperative CareSurgical Wound InfectionAgedAged, 80 and overChlorhexidineFemaleHumansMalePovidone-IodineProspective StudiesSkinTreatment OutcomeAnti-Infective Agents, LocalChlorhexidinechlorhexidine gluconatePovidone-IodineArthroplastyChlorhexidineHip fracturesPovidone iodineSurgical site infection

Identifiers

PMID42558178
PMCPMC13437159

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.