80 patients undergoing open spine surgery were randomized to receive intra-operative wound irrigation with a gentamicin/saline solution (n=40) or a diluted povidone-iodine solution (n=40). The outcome of interest was surgical site infection (overall; deep; superficial), the incidence of bacteria causative organisms, and the post-operative duration of surgical site occurrence. Follow-up occurred on days 5, 14, and 30 post-operation. The results revealed significantly lower rates of surgical site infection, particularly superficial infection, in the povidone-iodine group. Moreover, the incidences of surgical site infection rate and bacteria-causative organisms in the lumbosacral region were significantly lower in the povidone-iodine group. The results suggest that a povidone-iodine solution could provide significantly better infection prophylaxis over a gentamicin-based solution for patients undergoing open surgery. The findings are particularly relevant to non-Western countries, as this study was conducted in Nigeria.