Comparison between olanexidine gluconate and conventional antiseptics for surgical site infection in gastroenterological surgery: A meta-analysis

Aim: To compare the preventative effect of the new antiseptic olanexidine gluconate (OLG) with conventional antiseptics on surgical site infections (SSIs) in gastroenterological surgery. Methods: A comprehensive electronic literature search was conducted through November 2024 to identify studies comparing the occurrence of SSIs between OLG and conventional antiseptics (Conv), including povidone-iodine (PI) or chlorhexidine gluconate (CHG), for incisional site disinfection. The primary outcomes were the occurrence of overall SSI and incisional SSI (including superficial and deep incisional SSI). A meta-analysis was performed using random-effects models to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Results: Nine studies involving 7807 patients (OLG, n = 3491; Conv, n = 4316) were included. The overall SSI rates were 7.8% in the OLG group and 11.1% in the Conv group. OLG significantly reduced overall SSIs (OR: 0.65, 95% CI: 0.53–0.81, p < 0.001) without statistical heterogeneity. OLG also significantly reduced incisional SSIs (4.3% vs. 6.6%) (OR: 0.63, 95% CI: 0.49–0.81, p < 0.001) without statistical heterogeneity. Conclusions: To our knowledge, this is the first meta-analysis with a sufficient sample size to investigate the effect of OLG compared with other antiseptics, demonstrating that OLG significantly reduces overall SSIs and incisional SSIs in gastroenterological surgery without increasing adverse skin reactions. These findings may enhance SSI management for patients undergoing various types of surgeries by introducing new preventative strategies and potentially lowering SSI-related healthcare costs.