Largest Trial of Skin Antiseptics in Complex Fractures .

In one of the largest RCTs to date on open fracture care, the Aqueous-PREP trial examined whether antiseptic skin preparation influences surgical site infection risk. Conducted across 14 hospitals in three countries, over 1,600 patients were randomized to aqueous 10% povidone-iodine or 4% chlorhexidine gluconate. Infection and reoperation rates were similar, challenging long-held preferences and questioning assumptions drawn from non-orthopaedic surgery. Beyond clinical outcomes, this study showcased patient-engaged trial design and multinational collaboration—setting a new benchmark for pragmatic trauma research.