根据随机分配到三种阴道准备液（10% Beta-Jone碘伊、2%洗必泰或4%洗必泰）的患者接受腹腔镜子宫切除术后，测定菌群在阴道和子宫操作器中的生长差异。这是一项前瞻性随机对照试验，在一所学术社区医院进行。患者年龄≥18岁，计划进行良性和恶性病例的腹腔镜子宫切除术。每组随机分配了50名患者。术前，手术团队根据分组分配使用10% Beta-Jone碘伊、2%洗必泰或4%洗必泰进行阴道准备。在初始准备后、经阴道切口之前和子宫操作器表面采集培养物。基线阴道前穹窿/宫颈管培养物的细菌计数在三组之间没有显著差异。在第二次宫颈管/阴道前穹窿培养物中，细菌计数有差异（p < 0.01），Beta-Jone碘伊组培养物的生长水平最高（93.8%），其次是2%洗必泰（47.4%）和4%洗必泰（20%）。子宫操作器手柄的生长无差异，三组术后均无阴道瘙痒或烧灼感差异。在子宫切口术前细菌生长最低的是4%洗必泰，其次是2%洗必泰，Beta-Jone碘伊组细菌生长最高。在中度至重度阴道瘙痒或烧灼感方面没有差异。这表明在腹腔镜子宫切除术中，4%洗必泰在减少细菌生长方面具有优势。（由SLS，腹腔镜和机器人外科医生学会，2023年版权所有）

Determine the difference in microbial growth from the vagina and uterine manipulator among patients undergoing laparoscopic hysterectomy after randomization to one of three vaginal preparation solutions (10% Povidone-iodine, 2% Chlorhexidine, or 4% Chlorhexidine).This was a prospective randomized controlled trial in an academic community hospital. Patients were ≥ 18 years old and scheduled for laparoscopic hysterectomy for benign and malignant indications.Fifty patients were identified and randomized into each arm. Prior to surgery, the surgical team prepared the vaginal field using 10% Povidone-iodine, 2% Chlorhexidine, or 4% Chlorhexidine, according to group assignment. Cultures were collected from the vagina after initial preparation, prior to the colpotomy, and on surfaces of the uterine manipulator. Bacterial count from the baseline vaginal fornix/cervical canal cultures did not differ significantly among the three groups. There was a difference in bacterial count among the second cervical canal/vaginal fornix cultures (p < 0.01), with the Povidone-iodine arm demonstrating the highest level of growth of cultures (93.8%), followed by 2% Chlorhexidine (47.4%), and 4% Chlorhexidine (20%). There was no difference in growth on the uterine manipulator handle and no difference in vaginal itching or burning was found across the three arms postoperatively.Bacterial growth prior to colpotomy was the lowest with 4% Chlorhexidine followed by 2% Chlorhexidine, the Povidone-iodine group exhibited the highest bacterial growth. There was no difference in moderate to severe vaginal itching or burning. This showed that 4% Chlorhexidine is superior in reducing bacterial growth when used in laparoscopic hysterectomy.© 2023 by SLS, Society of Laparoscopic & Robotic Surgeons.