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Original ArticleOpen Access
Effectiveness of Vaginal Douching on Febrile and Infectious Morbidities after Total Abdominal Hysterectomy : A Multicenter Randomized Controlled Trial
Buppasiri P 
,
Chongsomchai C ,
Wongproamas N ,
Ounchai J ,
Suwannachat B ,
Lumbiganon P
,
Chongsomchai C ,
Wongproamas N ,
Ounchai J ,
Suwannachat B ,
Lumbiganon P Objective : To evaluate the effectiveness of vaginal douching with I per cent povidone-iodine
in reducing febrile and infectious morbidities after total abdominal hysterectomy (T AH).
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.
Key word : Total Abdominal Hysterectomy, Vaginal Douching
in reducing febrile and infectious morbidities after total abdominal hysterectomy (T AH).
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.
Key word : Total Abdominal Hysterectomy, Vaginal Douching
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