{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:06:04Z","timestamp":1790251564107,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001171","name":"Cancer Institute NSW","doi-asserted-by":"publisher","award":["CINSW 2020\/2081"],"award-info":[{"award-number":["CINSW 2020\/2081"]}],"id":[{"id":"10.13039\/501100001171","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100024053","name":"Sydney Local Health District","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n It is unknown whether the method of application of povidone iodine solution for skin antisepsis affects its efficacy. The primary aim of this study was to compare the efficacy of spray\u2010on aqueous povidone iodine solution in preventing surgical site infection in patients undergoing open head and neck surgery versus the standard paint\u2010on application of the same agent. The secondary objective was to assess if the use of spray\u2010on antiseptic solution reduced time in the operating room in complex head and neck surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a prospective, double\u2010blinded, noninferiority randomised controlled trial. The intervention arm received spray\u2010on application of 10% aqueous povidone iodine solution after induction of general anaesthesia. Those in the control arm underwent standard skin preparation by painted application of the same agent. Participants were reviewed on Days 7 and 30 postoperatively to identify postoperative surgical site infection.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Four\u2010hundred and forty adult patients undergoing open head and neck surgery were recruited. After withdrawals, 432 participants were included, with 210 patients in the intervention arm (spray) and 222 in the control arm (paint). The overall rate of surgical site infection was 6.5%. There was no significant difference in the rate of surgical site infection between the groups receiving spray\u2010on versus painted povidone iodine solution (5.7% and 7.2%, respectively,\n p<\/jats:italic>\n \u2009=\u20090.66). For patients undergoing free flap surgery, the mean time in the operating room was 12.9\u2009min less in the spray\u2010on arm; however, this was not statistically significant (95% CI \u221242.7 to 68.4\u2009min,\n p<\/jats:italic>\n \u2009=\u20090.65).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Spray\u2010on skin preparation with povidone iodine solution before open head and neck surgery appears to be as effective as traditional paint\u2010on application in preventing surgical site infection in the first 30\u2009days following surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ans.70772","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:48:38Z","timestamp":1782398918000},"page":"2448-2454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Randomised Controlled Trial Comparing Spray Versus Paint Application of Iodine Skin Antisepsis in Head and Neck Surgery"],"prefix":"10.1111","volume":"96","author":[{"given":"Jonathan M.","family":"Fussey","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head & Neck Surgery University Hospitals Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G. H.","family":"Manzie","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilusha","family":"Nanayakkara","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerwin F.","family":"Shannon","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten E.","family":"Palme","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Elliott","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Wykes","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4011-1253","authenticated-orcid":false,"given":"Sydney","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District Sydney New South Wales Australia"},{"name":"Department of Plastic Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsu\u2010Hui (Hubert)","family":"Low","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney Sydney New South Wales Australia"},{"name":"Department of Otolaryngology\u2014Head & Neck Surgery, Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masako","family":"Dunn","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1282-2313","authenticated-orcid":false,"given":"Miles","family":"Somers","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-772X","authenticated-orcid":false,"given":"Jonathan R.","family":"Clark","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health Sciences University of Sydney Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.007112"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0904"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30375-3"},{"key":"e_1_2_10_5_1","unstructured":"Global Guidelines for the Prevention of Surgical Site Infection \u201cWorld Health Organisation 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https:\/\/www.cdc.gov\/nhsn\/psc\/ssi\/index.html\/."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(59)90273-9"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.129922"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-015-0076-2"},{"key":"e_1_2_10_14_1","first-page":"363","article-title":"A Clinical Evaluation of Chlorhexidine Gluconate Spray as Compared With Iodophor Scrub for Preoperative Skin Preparation","volume":"158","author":"Brown T. 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