Chlorhexidine‐Alcohol Versus Povidone‐Iodine for Surgical Site Infection Prevention in Abdominal Surgery in Low‐ and Middle‐Income Countries: A Systematic Review and Meta‐Analysis

BACKGROUND: Surgical site infections remain disproportionately common in low- and middle-income countries (LMICs). We systematically reviewed and meta-analyzed evidence comparing chlorhexidine-alcohol (CHG-ALC) and povidone-iodine (PI) for preoperative skin antisepsis in abdominal surgery in LMICs. METHODS: , Cochran's Q statistics, Egger's regression, and funnel plot-based methods. RESULTS: = 90.8%). CONCLUSION: CHG-ALC appears more effective than PI for reducing SSI after abdominal surgery in LMICs overall, with the most consistent evidence observed in South Asia. However, evidence from sub-Saharan Africa remains limited and heterogeneous. These findings support context-specific implementation and the need for additional African trials focused on abdominal procedures and clearly defined wound classes.