Search

Background: There is currently no consensus among plastic surgeons regarding the optimal infection prophylaxis for immediate tissue expander placement following mastectomy. The goal of this study was to determine whether irrigation with 1 L of standard triple antibiotic solution (TAS) can achieve similar infection rates compared to a regimen of 180 mL of TAS with povidone-iodine solution (Betadine) painted on the field immediately prior to the placement of the expander. Methods: The 2 regimens were compared via retrospective propensity matching of all patients of the 2 senior authors who underwent bilateral tissue expander placement immediately following mastectomy with one of 3 mastectomy surgeons from January 2013 to December 2019 (n = 281). Groups were controlled for mastectomy surgeon, mastectomy type, mastectomy weight, age, race, body mass index, diabetes, hypertension, smoking, smoking status, prepectoral/subpectoral placement, use of acellular dermal matrix, operating room time, and duration of postoperative antibiotics. Results: Compared to the Betadine cohort (n = 65), the non-Betadine cohort (n = 65) experienced a similar rate of infections (13.8% vs 12.3%, P = 1.00), including major injections requiring intravenous antibiotic treatment (10.8% vs 9.2%, P = 1.00), after propensity matching. Infections in the non-Betadine cohort did not grow different bacteria on culture, require different antibiotic coverage, or result in prolonged duration of average antibiotic therapy (12.0 days vs 19.3 days, P = .19). Rates of subsequent expander washout and exchange ( P = 1.00) and overall complications that required return to the operating room ( P = .826) were similar between groups. Conclusion: The addition of Betadine solution to TAS added no benefit to infection prophylaxis or reduction of surgical complications in immediate tissue expander placement procedures.

Objective: Deep wound infection can worsen clinical outcome and increase costs following spinal surgery. The bactericidal activity of povidone-iodine covers a broad spectrum of pathogens including methicillin-resistant Staphylococcus aureus. Our study aimed at evaluating the role that intraoperative dilute povidone-iodine solution irrigation could play in preventing post-operative wound infection following spinal surgery. Material and Methods: The clinical data of 41 patients that had undergone posterior spinal surgery in the department of neurosurgery Allama Iqbal hospital Sialkot was retrospectively analyzed. We divided the patients into two groups. In group 1patients wounds were irrigated with 0.35% povidone-iodine solution prior to closure. In group 2 patients wounds were irrigated with normal saline only. The two groups were then compared for evaluation of efficacy of peroperative povidone-iodine solution irrigation in preventing post-operative wound infection. Results: No infection occurred in the 16 patients in group 1 in whom wounds had been irrigated with povidone-iodine solution, compared to 3 deep infections developing in the 25 patients in group 2 in whom wounds had been irrigated with normal saline only. In the 3 patients that suffered from deep infections the duration of hospital stay was also significantly increased (P < 0.05). Conclusion: Our study supports the notion that perioperative povidone-iodine irrigation is an effective adjunct measure for prevention of surgical site infection following spinal surgical interventions.

Study Design: A retrospective case-controlled study. Objectives: To evaluate overall infection rate and adverse event after harvesting bone graft soaking and surgical wound irrigation by povidone iodine solution (PVI) in the minimally invasive instrumented spinal fusion surgery. In order to reduce the rate of surgical site infection in spinal surgery, surgical wound irrigation by povidone iodine solution has been well-established. However, the efficacy of autologous bone graft soaking by PVI has not been evaluated before. Methods: This is a retrospective cohort study. 120 patients were enrolled in the PVI group and compared with 124 patients in the historical cohort. In the PVI group, the harvesting autologous bone graft was soaking and the surgical wound was also irrigated by diluted PVI solution. The outcome measures were overall infection rate, superficial wound infection and deep infection. In addition, the delayed union of the fusion mass was also evaluated through the radiograph evaluation. Results: Both groups shared similar patient demographics instead of body mass index. The use of PVI solution had decreased the overall infection rate (0% versus 4.03%, p = 0.026) and deep infection rate (0% versus 3.23%, p = 0.047). In addition, there was no delayed bone healing in the PVI group after autologous bone graft soaking. Conclusions: In this study, we conclude that harvested autologous bone graft after PVI soaking in spinal fusion surgery can decrease the incidence of deep infection.

Peritoneal Dialysis (PD) utilization increases gradually due to increase of patient's awareness for different types of Renal Replacement Therapy (RRT). Hence, in order to be successful with PD program, we need to build strong strategies to improve patients’ quality of care. One of the risks associated with PD is the Exit-Site-Infection (ESI).

Background Nasal topical treatments can provide an effective method of disease control for patients suffering from chronic rhinosinusitis (CRS). However, some frequently used formulations lack adequate evaluation on their safety. This study investigated the effect of 0.5% povidone-iodine (Nasodine) on the sinonasal epithelial barrier and ciliated human nasal epithelial cells (HNECs) in vitro. Methods Nasodine was applied to air-liquid interface (ALI) cultures of primary HNECs from CRS patients. Epithelial barrier structure was assessed by measuring the transepithelial electrical resistance (TEER), paracellular permeability, and immunolocalization of the zona occludens-1 (ZO-1) tight junction protein. Toxicity and ciliary beat frequency (CBF) were also studied. Results Nasodine was not toxic and did not have detrimental effects on the paracellular permeability or CBF. Nasodine did not show a significant reduction in TEER with a 5-minute exposure; however, with a 30-minute exposure there was a significant reduction in TEER at 1 hour and at 4 hours after exposure. Conclusion Application of Nasodine to HNEC-ALI cultures in vitro for up to 30 minutes was not toxic and did not affect the paracellular permeability or CBF.

Objective: To evaluate the efficacy of pre-cesarean vaginal wash using 5% Povidone Iodine solution on rate of post-cesarean section (CS) surgical site infection and compared with No swabbing. Method: A Prospective Randomized controlled Trial was conducted in department of Obstetrics and Gynecology in Government medical college, Aurangabad. In interventional group, vaginal swabbing with a gauze pieces impregnated with 5% Povidone Iodine solution was done for 30 seconds. The swabbing of vagina was not performed in cases assigned to control group, however the standard surgical preparation of abdomen was done in a usual manner for both group. All subject received prophylactic antibiotic cover. Collected data was complied in pre-designed proforma and analysis was done using SPSS 15. Result: The risk of post operative fever and wound infection was significantly reduced in interventional group. No measure difference was noted in seroma and composite wound infection. Also less duration of hospital stay in interventional group was noted. No adverse effect of use of Povidone iodine was reported in the interventional group. Conclusion: Vaginal swabbing with 5% Povidone-iodine pre- LSCS is inexpensive and simple intervention even for low resource setting to decrease surgical site infection.

Periprosthetic joint infection is a major complication of total joint arthroplasty (TJA). The intraoperative splash basin has been found to be a potential source of contamination. Although consensus recommendations against the use of splash basin have been made, splash basin use continues to be taught and utilized in practice. This study aims to investigate the effect of dilute betadine addition to the sterile water (SW) contents (0.02% solution) of the splash basin on contamination rates. This intervention could preserve the functionality and preferential use of the splash basin. The primary outcome of this study is the rate of splash basin contamination, with secondary outcomes of prevalence of culture speciation and mean operative times association with the rate of positive cultures.Patients undergoing primary TJA were enrolled in a randomized controlled trial with assignment to either the intervention/betadine group, in which dilute betadine was added to the standard SW splash basin, or the control/standard SW group. For a total cohort of 104 patients, a 120 mL aliquot sample of basin fluid was collected at incision ("preprocedure") and closure ("postprocedure"). Samples were cultured and monitored for 48 hours for growth, with further testing as necessary to identify microbial speciation.Of the final 100 postprocedure samples, 0 (0.0%) were positive in the betadine group, while there were 23 (47.9%) positive samples in the SW group (P.001). Of the positive cultures, the most common species grown were coagulase-negative Staphylococcus, Corynebacterium, and Micrococcus. The mean operative time was an average of 11 minutes longer for cases with positive cultures.In conclusion, treating SW splash basins with dilute povidone-iodine (0.02% solution) eliminates intraoperative contamination of splash basins in TJA procedures. This intervention is simple, low cost, and readily implementable, making it a reasonable addition to TJA protocols.Level 1, Controlled Laboratory Study.

Background: Non-Hodgkin's The current study aims to study the effectiveness of Betadine versus Normal saline dressing on episiotomy wound healing. A quasi experimental study included a Simple random sample of 160 postnatal women (80 mothers used saline dressing and 80 mothers used povid one iodine solution (10%) who had normal vaginal delivery with episiotomy from Ain Shams University Maternity Hospital). Three tools were used for data collection; I. Structured-interviewing questionnaire sheet, II. Standardized REEDA scale and III. Visual Analogue Scale. The results revealed that normal saline had a positive effect on the healing of episiotomy wound among postnatal mothers in form of lower REEDA scale score and pain scores (VAS). The study recommended that; educational session to increase women awareness about use of normal saline after episiotomy in form of leaflet or counseling session should be adopted. There should be integration of the saline dressing as a main part in discharge plan. Further researches to replicate the study on large sample to determine the factors affecting episiotomy wound healing should be applied.

Background: Chlorhexidine Gluconate (CHG), Hibiclens (4% CHG with 4% Isopropyl Alcohol Detergent), and Chloraprep (i.e. labeled CHG-based solutions), utilized as preoperative surgical preparatory solutions may all cause severe oculotoxicity and ototoxicity. Alternatively, 10% Povidone-Iodine (PI) solutions without detergent demonstrate minimal toxic effects on the eyes and ears. Methods: Based on studies from 1984 to 2021, we compared the safety/efficacy of CHG-based versus PI-based solutions utilized for presurgical skin preparation near the cornea/eyes and ears (i.e., predominantly for cranial or cervical spine surgery). Results: Some studies documented that even minimal exposure (i.e., “splash risk”) during face/neck skin preparation with CHG-based solutions could result in irreversible corneal injury and ototoxicity. Within minutes to hours, CHG-based non-detergent solutions posed the risks of; corneal epithelial edema, anterior stromal edema, conjunctival chemosis, bullous keratopathy, and de-epithelialization. Notably, even occlusive dressings like Tegaderm could not protect against CHG penetration. Alternatively, PI-based solutions posed no to minimal ocular and/or ototoxicity, while often demonstrating comparable protection against surgical site infections (SSI). Conclusion: Chlorhexidine Gluconate (CHG), Hibiclens, and Chloraprep (i.e. CHG-based solutions) are often used as skin preparations near the face/eyes/spine (i.e., particularly anterior/posterior cervical procedures). However, if these solutions come in contact with the eyes, corneal irritation, abrasions, and even blindness may result. Alternatively, PI non-detergent solutions demonstrate safety/minimal oculotoxicity/ototoxicity, while frequently showing comparable efficacy against SSI.

Nowadays, povidone-iodine is commonly used as a disinfectant in head and neck procedures. The present study investigated the effect of povidone-iodine, which is used as a disinfectant solution in tympanoplasty, on patients' hearing.A povidone-iodine solution was used as disinfection in chronic otitis media patients undergoing tympanoplasty. In the intervention group, 5% povidone-iodine, was applied to the external auditory canal and remained there for 10 minutes. In the control group, povidone-iodine was used but not allowed to enter the external auditory canal by inserting cotton wool into the canal. To evaluate the adverse effect of povidone-iodine on hearing, the bone conduction level was compared between groups at baseline and one month after exposure.Bone conduction levels at frequencies 500 Hz, 1 kHz, 2 kHz, 3 kHz, 4 kHz and 8 kHz and mean of bone conduction level in 500 Hz, 1 kHz and 2 kHz were measured and compared respectively between intervention and control group. No significant difference was seen between bone conduction levels of above frequencies and mean frequencies before and one month after surgery. (P-value = 0.321, 0.432, 0.219, 0.489, 0.61, 0.112, 0.324 respectively).According to the present study, currently available 5% povidone-iodine did not affect hearing and therefore, can be comfortably used for preparation and disinfection in otologic surgeries.Valutazione della sicurezza nell’utilizzo della soluzione con iodopovidone nella timpanoplastica: studio placebo-controllo, in triplo cieco randomizzato.Al giorno d’oggi, lo iodio-povidone è comunemente usato come disinfettante nelle procedure della testa e del collo. Il presente studio ha esaminato l’effetto del povidone-iodio, che viene utilizzato come soluzione disinfettante nella timpanoplastica, sull’udito dei pazienti.La soluzione di iodio-povidone è stata utilizzata come disinfettante in pazienti con otite media cronica sottoposti a timpanoplastica. Nel gruppo di intervento, lo iodio povidone al 5% è stato applicato al canale uditivo esterno e vi è rimasto per dieci minuti. Nel gruppo di controllo, è stato usato iodio-povidone ma non gli è stato permesso di entrare nel canale uditivo esterno inserendo un batuffolo di cotone nel canale. Per valutare l’effetto avverso dello iodio-povidone sull’udito, è stato valutato il livello di conduzione ossea nei gruppi di trattamento, prima dell’intervento e un mese dopo l’esposizione.Vengono misurati e confrontati i livelli di conduzione ossea a frequenze di 500 Hz (hertz), 1 kHz (kilohertz), 2 kHz, 3 kHz, 4 kHz e 8 kHz e il livello medio di conduzione ossea a 500 Hz, 1 kHz e 2 kHz rispettivamente tra gruppo di intervento e gruppo di controllo. Non è stata osservata alcuna differenza significativa tra i livelli di conduzione ossea delle singole frequenze e delle frequenze medie prima e un mese dopo l’intervento chirurgico. (Valore P = 0,321, 0,432, 0,219, 0,489, 0,61, 0,112, 0,324 rispettivamente).Secondo il presente studio, iodio-povidone al 5% attualmente disponibile non ha diminuito l’udito e quindi può essere tranquillamente utilizzato per la preparazione e la disinfezione nella chirurgia otologica.

Industrial chemical solutions are widely used as a method to disinfection of aquaculture water and environments. The aim of the present study was to evaluate the toxicity effect of Betadine (10% solution of povidone-iodine) as a disinfectant solution on the survival and gill tissue of Oranda goldfish (Carassius auratus). For these purposes, 225 fingerling Oranda goldfish with an average weight 5 ± 0.67 g were divided into 15 groups with 3 replications. Fish were exposed to series of concentrations (0, 10, 20, 40, 60, 80, 90, 100, 120, 140, 160, 180, 200, 220 and 240 mg/L) of Betadine for 96 h. The mortality of fish and the samples of gill were observed at 6, 12, 18, 24, 48, 72 and 96 h after exposure. The results of the present study showed that the half-life of Betadine was less than 24 h and mortality were not record after 24 h. The highest mortality rate was at 240 mg/L, and LC50 24 h of Betadine was 158.800 mg/L. Histopathological results showed that lethal concentrations of Betadine lead to hyperemia, hypertrophy, hyperplasia and adhesion of secondary lamellar of the gill. Moreover, fish that were exposed to these concentrations displayed clinical signs such as anxiety, darkening of the skin. Overall results showed that Betadine have short half-life in the aquatic environment and are toxic to fish at very high concentrations, therefore it can be considered as practically non-toxic and useful for disinfection of the aquatic environment.

Luka adalah cedera fisik yang mengakibatkan rusaknya kulit. Penanganan luka diperlukan untuk mencegah terjadinya infeksi. Agen topikal untuk luka insisi ekstraoral yang umumnya tersedia di puskesmas dan klinik-klinik kesehatan umum maupun gigi yaitu solutiopovidone iodine 10% dan unguentum kloramfenikol 2%. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat perbedaan waktu penutupan luka insisi yang diaplikasikan solutiopovidone iodine 10% dengan unguentum kloramfenikol 2% pada mencit Swiss Webster. Penelitian ini bersifat eksperimental laboratorik, menggunakan 30 ekor mencit Swiss Webster yang dibagi menjadi 2 kelompok. Kelompok I adalah luka insisi pada paha kanan mencit dan diaplikasikan solutiopovidone iodine 10%. Kelompok II adalah luka insisi pada paha kiri mencit dan diaplikasikan unguentum kloramfenikol 2%. Data yang diukur adalah rerata waktu penutupan luka insisi untuk kedua kelompok, kemudian dianalisis menggunakan uji non parametrik Mann-Whitney. Rerata waktu penutupan luka insisi yang diaplikasikan solutiopovidone iodine 10% adalah 5,07±0,691 hari, dan yang diaplikasikan unguentum kloramfenikol 2% adalah 5,03±0,765 hari. Simpulan penelitian adalah tidak terdapat perbedaan waktu penutupan luka insisi yang diaplikasikan solutio povidone iodine 10% dengan unguentum kloramfenikol 2% pada mencit Swiss Webster. Kata kunci: waktu penutupan luka, luka insisi, solutio povidone iodine 10%, unguentum kloramfenikol 2%

Background The COVID-19 pandemic has raised concerns of inadvertent SARS-CoV-2 transmission to healthcare workers during routine procedures of the aerodigestive tract in asymptomatic COVID-19 patients. Current efforts to mitigate this risk focus on Personal Protective Equipment, including high-efficiency filtration as well as other measures. Because the reservoir for SARS-CoV-2 shedding is in the nasopharynx and nasal and oral cavities, the application of viricidal agents to these surfaces may reduce virus burden. Numerous studies have confirmed that povidone-iodine inactivates many common respiratory viruses, including SARS-CoV-1. Povidone-iodine also has good profile for mucosal tolerance. Thus, we propose a prophylactic treatment protocol for the application of topical povidone-iodine to the upper aerodigestive tract. Conclusion Such an approach represents a low-cost, low-morbidity measure that may reduce the risks associated with aerosol-generating procedures performed commonly in otorhinolaryngology operating rooms. Graphical abstract

Povidone-iodine (PVI) is an effective disinfection solution for surgical wounds. However, there is some reports of its adverse effects on wound healing and bone reunion. Here, we evaluate the efficacy and safety of PVI irrigation in the prevention of surgical site infection in spinal surgery.

A total number of 36 cross bred jersey cows with external teat injury without involving the teat cistern and with exposed teat sinus were subjected for the present study. Clinical examination of teat for its shape, length, distance from the ground and etiology of the teat wounds were recorded. Following preoperative evaluation, the animals were divided into Group I with 12 animals and treatment group with 24 animals each. Group I were treated with Povidone iodine solution. In treatment (Group II), after suturing the wound was protected with sheets of collagen and calcium alginate as protectants. The application of collagen based teat protectant is an effective methodology for favoring healing process of external injuries when compared to the conventional antiseptic drugs using Povidone iodine.

The FloShield Air System® is a new device for laparoscopic surgery that utilizes a continuous dry CO2 gas flow over the scope to defog the lens and protect it from condensation, debris and smoke. We set out to compare the performance and efficiency of the device in terms of operative lens vision quality (OLVQ) with the reference technique (water + povidone-iodine (PVI) solution) during gynecologic laparoscopic surgery. We conducted a single-center randomized prospective study between March and June 2016 (Trials Database Registration NCT02702531) including 53 patients undergoing gynecologic laparoscopic surgery with water + PVI solution and 51 patients who underwent surgical procedures with the FloShield Air System. The primary outcome measure was the number of laparoscope removals during surgery. Secondary outcome measures were the time to clean, assessment of the quality of vision, the correlation between the laparoscopic surgical complexity and outcomes, and cost effectiveness. Overall, the mean patient age was 43.2 years (range 22–86) and body mass index 24.8 (range 16.8–42.7). The mean number of endoscope removals during surgery was 7.0 (range 0–37) in the water + PVI solution arm and 2.8 (range 0–12) in the FloShield Air System® arm. The number of removals was significantly lower in the FloShield arm (p

The purpose of this work was to evaluate the antimicrobial activity of povidone-iodine solution as a photosensitizer and effective optical range of laser activation identification in vitro. Materials and Methods. As the test cultures reference strains of Candida albicans ATCC 885-653, Staphylococcus epidermidis ATCC 14990, Escherichia coli ATCC 25992, Pseudomonas aeruginosa ATCC 27853, Enterococcus faecalis ATCC 6783 were used. 10 % povidone-iodine solution was added to Petri dishes with the microorganisms on agar and was left in situ for 60 seconds. Fifteen test Petri dishes were irradiated using the remote handle VRV4 λ = 658 nm (Test 1), the other fifteen – with the handle VRIP1 λ = 810 nm (Test 2). Four controls were carried out: the first control (C1) – Petri dishes with inoculated culture without the povidone-iodine solution and laser irradiation influence. The second control (C2) – the photosensitizer was not irradiated. The third control (C3) – it was the irradiation by wavelength 658 nm without chromatophore using. The fourth control (C4) – it was the irradiation by wavelength 810 nm without chromatophore using. Results. The obtained data have shown that povidone-iodine solution was activated in the infrared optical range, as evidenced by the complete absence of test microorganisms growth in Petri dishes “Test 2”. It was found out a reliable decrease in the number of microorganisms colonies in the Petri dishes “Test 1”, but it was achieved by the povidone-iodine antimicrobial activity, rather than by laser activation. This is confirmed by the fact that the number of microorganisms colonies in the Petri dishes ”Test 1” was not statistically different from the number of colonies in the second control group where povidone-iodine solution was not irradiated. Conclusions. It has been proved that the photosensitizer 10% povidone-iodine solution was activated by 810-nm wavelength laser irradiation in the infrared optical range. There had been no growth of microorganisms in nutrient media in test plates compared to the control.

Background: A prospective randomized control trial (RCT) was conducted in the department of obstetrics and gynecology. The aim of the study was to evaluate the effect of pre-operative vaginal preparation with 1% povidone iodine solution on the post-operative caesarean infectious morbidity.Methods: 72 women were enrolled in the experimental group who received 1% povidone iodine vaginal wash and 72 in the control group who did not receive any vaginal wash. The investigators were blinded to the computer-generated random number table and to the allocation group. The clinical data was recorded and after its completion, the allocation group was revealed to the investigator. The data was tabulated and statistically analyzed using SPSS 21.Results: Age, parity, BMI, gestational age, blood loss, and operative time between the two groups was comparable. Pre-operative povidone iodine vaginal wash was more effective when membranes were intact versus ruptured. With intact membranes, statistical significance was reached for postoperative fever, seroma, endometritis, gaped incisional site, and foul discharge with p value 0.012, 0.012, 0.013, 0.027 and 0.012 respectively, between group A and B. The overall infectious morbidity in the 144 subjects showed statistical significance for endometritis, and foul-smelling lochia with p value 0.049 and 0.024 respectively; urinary tract infection, hospital stay duration, and incisional wound dehiscence were higher in group B versus group A, the difference in these parameters did not reach statistical significance.Conclusions: Pre-operative vaginal cleansing with 1% povidone iodine reduced post-operative infectious morbidity more effectively in those with intact membranes than ruptured membranes.

Background: Establishing continuity of the cutaneous roll is critical to cleft lip repair. Unfortunately, this landmark can be difficult to appreciate depending on the patient’s skin tone, surgical lighting, or preexisting scar. Solution: When applied to the lip, dilute povidone-iodine solution beads off the cutaneous roll and dry vermilion, clearly defining these structures. What We Do: We use dilute povidone-iodine solution not only to prep the lip but to delineate landmarks critical to cleft lip repair.

Background: Chlorhexidine and povidone – iodine solution are both well-known skin disinfectants. In this study we have compared the efficacy of chlorhexidine against povidone – iodine solution. Methods: 100 patients undergoing elective surgeries were divided into 2 groups of 50 each. Group CHD was cleansed with chlorhexidine gluconate 2% in 80% alcohol and group PV-I group was treated with 10% aqueous solution of povidone iodine. Two swabs were taken from the site of surgery, one before skin disinfection and one after and sent to the microbiology lab where they were cultured on Mac Conkey and Blood Agar and the magnitude of growth was reported. Results: The demographic details of both the groups were similar. 19 patients and 13 patients in the CHD and PV-I groups had growth prior to disinfection, while after disinfection, there was no bacterial growth in any of the patients in CHD group and 2 patients had poor growth in PV-I group. Conclusions: Though both the disinfectants were very effective, CHD was slightly better than PV-I. The cost and side effects were similar in both the cases. Since the drying time of CHD was faster than that of PV-I, CHD was a better choice, especially in emergency cases.

Objective To compare bacterial colonization after diluted iodine tincture or povidone iodine solution for presurgical disinfection of the equine peripodal region. Study design Complete block design. Animals Five horses. Methods Disinfection protocols using iodine tincture or povidone iodine solutions were tested on 5 pairs (n = 10) equine front feet. Iodine tincture was applied to the left feet and povidone iodine to the right feet. Fixed surfaces of the sole, frog, hoof wall, and peripodal skin were swabbed pre-preparation (T0), after a standard pre-disinfection step (T1), after short disinfection with a 4-minute application of 0.5% iodine tincture or povidone iodine (T2), and after long disinfection with 12-hour soaking in 0.25% iodine tincture or povidone iodine (T3). Quantitative bacteriology was performed on each swab. Results The frog and sole were the most contaminated sites compared to hoof wall and skin at T0. Bacterial counts were significantly decreased at T2 for both solutions. Bacterial counts did not change significantly with iodine tincture at T3 but increased with povidone iodine compared to T2. Skin abrasions were detected on almost all feet but were subjectively more severe on iodine tincture-treated feet. Conclusion Soaking for 12 hours with either iodine tincture or povidone iodine is not recommended as these solutions damaged the skin and bacterial recolonization was noted with povidone iodine. Four-minute disinfection using either iodine tincture or povidone iodine (0.5% available iodine) is appropriate for presurgical preparation of the equine peripodal region.

Introduction Topical application of tranexamic acid to the knee joint before closure in total knee arthroplasty reduces postoperative bleeding without increase in complication. However, it is unknown the effectiveness of topic TXA performed with other topical medications, like povidone-iodine solution. Materials and methods One hundred and twenty-five patients were randomized to receive 100 mL of povidone-iodine solution (control: group A) or 1.5 (group B) and 3.0 g (group C) of topical TXA in povidone-iodine solution applied into the knee before closure in total knee arthroplasty. Results The patients in the TXA groups had higher mean postoperative hemoglobin levels ( P = 0.01 and P = 0.03 in groups B and C, respectively) and a reduced postoperative blood loss in the TXA groups ( P = 0.07 and P = 0.09 in groups B and C, respectively). No significant complications were observed. Discussion In this study, topical application of tranexamic acid after total knee arthroplasty together with povidone-iodine solution results in higher postoperative hemoglobin levels and lower blood loss compared with those in the control group without other complications. Level of evidence I – I: high-powered prospective randomized trial.

A three-year-old Jersey cross breed cow was referred with the history of recent calving and congenital absence of three teats. Clinical examination revealed that the udder was normal and engorged with milk. The right fore teat was normal in shape without any physical abnormalities. There was absence of left fore, left hind and right hind teats and they were represented by small eruptions. Permanent therapeutic cessation of lactation was achieved successfully by intramammary infusion of each affected quarter with 120 ml of 5 % povidone iodine solution.

Background Although peritoneal lavage with povidone-iodine (PVPI) is frequently performed after surgery on the gastrointestinal tract, the effects of PVPI on the intestinal epithelial barrier are unknown. The purpose of this study was to investigate the effects of abdominal irrigation with PVPI on the intestinal epithelial barrier in a colorectal cancer (CRC)–induced rat model. Materials and methods The CRC model was induced in rats with azoxymethane and dextran sodium sulfate. Next, a total of 24 male CRC-induced rats were randomly divided into three groups ( n = 8): (1) a sham-operated group, (2) an NS group (peritoneal lavage 0.9% NaCl), and (3) a PVPI group (peritoneal lavage with 0.45%-0.55% PVPI). The mean arterial pressure was continuously monitored throughout the experiment. The levels of plasma endotoxin and D-lactate, blood gases, and protein concentration were measured. The ultrastructural changes of the epithelial tight junctions were observed by transmission electron microscopy. Results The mean arterial pressure after peritoneal lavage was lower in the PVPI group than that in the NS group. The protein concentration and levels of endotoxin and D-lactate were higher in the PVPI group than they were in the PVPI group. In addition, PVPI treatment resulted in a markedly severe metabolic acidosis and intestinal mucosal injury compared with NS rats. Conclusions Peritoneal lavage with PVPI dramatically compromises the integrity of the intestinal mucosa barrier and causes endotoxin shock in CRC rats. It is unsafe for clinical applications to include peritoneal lavage with PVPI in colorectal operations.

The quality of water in a dental unit used for cooling and flushing the high and low speed handpiece, air/water syringes and the scalers is of considerable importance. The present study was carried out to enumerate and identify the microorganisms present in water samples collected from dental unit waterlines of different dental specialty clinics and to find out the efficacy of two treating agents in disinfecting dental unit waterlines. Study design: Sample included 70 dental unit waterlines from different speciality dental clinics which were checked for microbial contamination. From these dental units 40 units were randomly selected and divided into two groups of 20 each. Group A, treatment was done in 20 dental units with 0.2% Chlorhexidine gluconate solution and Group B, treatment was done in 20 dental units with 10% Povidone iodine solution and the reduction in the microbial levels were assessed. Five dental units were randomly selected and checked the microbial contamination using mineral water, sterile distilled water, fresh tap water as a water source in the dental unit reservoir bottles. Also from the test group, five from each group were checked for the duration of efficacy of treating agent for one week by analyzing the water samples collected on 3 ,5 and 7 day intervals. Results: Most of the identified microorganisms are Gram negative and pseudomonas predominating up to 98.59% of the total isolates. Usage of disinfectants 0.2% Chlorhexidine and 10% Povidone Iodine were found to be very effective in reducing the microbial contamination and 10% Povidone iodine was found to be more efficient (97.13%) and active for a period of 3 days and gradually loosing its efficacy by 7th day. No significant difference were found in microbial contamination of water samples collected from different water outlets such as handpiece outlets, air water syringe outlets, scaler lines. Conclusion: To continue maintaining the sterility of the Dental unit waterlines and to complete the infection control measures adopted in the dental clinics, suitable disinfectants like 0.2% Chlorhexidine on daily basis or 10% Povidone iodine on every 3rd day basis intermittently maintain the sterility of dental unit waterlines it is essential to have a good water source and an effective disinfectant.

Background. Deep wound infection in spine surgery is a debilitating complication for patients and increases costs. The objective of this prospective study was to evaluate the efficacy of wound pulse irrigation with a dilute povidone-iodine solution in the prevention of surgical site infection.Methods. 50 patients undergoing spinal surgery were randomly divided into two groups (A and B) of 25 patients each. In group A, wounds were irrigated with dilute (3%) povidone-iodine solution through a low-pressure pulsatile device. In group B, wounds were irrigated with saline solution through a bulb syringe. In both groups, specimens for bacterial culture were harvested from surgical site before and after irrigation.Results. In group A, no surgical site infection occurred; in group B, deep wound infection was observed in 3 patients. In both groups, before irrigation some cultures have been found positive for bacterial contamination.Conclusion. Our study seems to support the idea that low-pressure pulsating lavage of surgical wounds with povidone-iodine diluted to a nontoxic concentration of 3% is an effective therapeutic adjunct measure to prevent surgical site infection in spine surgery. However, the number of the enrolled patients is small and a significant statistical analysis is not practicable. This trial is registered withNCT03249363.

The main purpose of the study was to compare the antimicrobial efficacy of chlorhexidine gluconate (CHG)–alcohols and a povidone–iodine (PVP–I) solution on the skin. The efficacy on the antecubital fossa, the abdomen and the inguen was evaluated to a maximum of 24 h after treatment by testing 74 healthy adult subjects according to an ASTM standard method. Relative to baseline microbial populations, all products produced significant reductions in population at all sites (P 0.05); this applied equally at the other sites tested. Given that Japanese pharmaceutical regulations limit CHG content in antiseptics to a maximum of 1%, it would be reasonable to expect that a 1% CHG–ethanol skin preparation could be chosen in Japan that would perform well and have promising potential for catheter preparation and/or maintenance preparation.

Povidone-iodine solution (Betadine®) has long been accepted as an effective topical broad spectrum antiseptic, disinfectant, and tumoricidal agent. In colorectal operations, this solution generally has been used for the purpose of minimizing postoperative septic complications and reducing cancer recurrence, although the optimal application, advantages, and undesirable side effects have been debated. With limited prospective, randomized, controlled trials and insufficient data available, this article examines the safe and effective clinical applications of this solution for colorectal operations.

Summary Povidone-iodine solution is currently employed for pin-site care in many institutions. There are concerns that this agent reacts with the metal pins and can impede healing. This study compared two different treatment protocols for the care of the skin surrounding skeletal pin-sites. This practical clinical trial, employing stratified sampling, compared 10% cutaneous povidone-iodine solution with soft white paraffin ointment for the treatment of skeletal pin-sites. The end points of the study were the presence of clinical signs of pin-site inflammation and/or infection and pin removed as treatment was completed. Data were analysed on 116 pin-sites from 18 patients. Seventy-two pins (62%) were treated with povidone-iodine and 44 (37.9%) with paraffin ointment. The group treated with soft white paraffin ointment more frequently developed clinical signs of infection ( n =15; 34.1%) than the povidone-iodine treatment group ( n =13; 18.1%) ( χ 2 (df)=3.8(1); p =0.05). Also, 43.8% of pin-sites on the medial aspect of the lower leg displayed inflammation/infection compared with 16.7% of other lower limb pin-sites ( χ 2 (df)=9.28(1); p =0.002). The use of an antibacterial agent in the management of skeletal pin-sites reduces the likelihood of infection. Further studies are needed to determine whether anatomical position of the pin-site is a risk factor for the development of pin-site infection and whether intervention could reduce inflammation/infection at medial lower limb pin-sites.

Introduction: Gunshot wounds are commonly encountered in war as well as in civilian situation. Experience of treating low velocity gunshot wounds (GSW) as outpatients in a war situation is depicted in this study. Aim: The aim of this study was to evaluate the experience of treating low velocity gunshot wounds by simple wound irrigation and marginal excision in war situation. Method: This was a retrospective observational study carried out in a Level-II Hospital of United Nations in Ivory Coast over a period of 7 months. All patients of low velocity GSW were treated with simple wound irrigation with normal saline and povidone iodine solution with excision of wound margin of doubtful viability under local anesthesia, rather than wound debridement. Result: All wounds healed with 6% superficial wound infection that was controlled with oral antibiotics. Conclusion: Outpatient management of low velocity GSW with wound irrigation and marginal excision is an effective method of treatment that can save time, money and hospital-stay. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10388 JAFMC 2011; 7(2): 12-14

We report 19 patients who developed extensive patchy or linear erythema on both sides of the buttocks, the back and the posterior areas of the thighs within a few days following operations or cardioangiography. The erythema was sometimes deeply infiltrative and was also accompanied by bullae and erosion. Patch tests of the patients were strongly positive for 10% povidone-iodine (PVP-I, Isodine®) solution; however, they were negative for 10% PVP-I solution with the same amount of 8% sodium thiosulfate and for 5% potassium iodide in petrolatum. In all control individuals, the only positive result was that of a patch test with 10% PVP-I solution within 8 h after application. We diagnosed our patients as having irritant contact dermatitis caused by 10% PVP-I solution during the procedure, which might have drained along the skin to the side of the buttocks or the back. We here indicate that prolonged contact with a large quantity of 10% PVP-I solution should be avoided to prevent this problem.

We report the successful repair of a ruptured abdominal aortic aneurysm in a 66-year-old man. He was admitted with cardiopulmonary arrest. Emergency surgery was successfully performed after cardiopulmonary resuscitation. Although postoperative MRSA infection developed in the retroperitoneal cavity, it was treated by continuous irrigation with 1% povidone iodine solution. He was discharged without any neurological difficulty and returned to his usual life.

To investigate the ototoxic effects of different concentrations of povidone-iodine solutions applied to the middle ear cavity of rats using distortion product otoacoustic emissions. 24 healthy 3–3.5-month-old adult female Sprague-Dawley rats were randomly divided into three groups. The group A (n = 8 ears) received 5 % povidone-iodine solution to the right ear, the group B (n = 8 ears) received 7.5 % povidone-iodine solution to the right ear and the group C (n = 8 ears) received 10 % povidone-iodine solution to the right ear. All animals received saline solution to the left ear as a control (n = 24 ears). The animals were tested before, 1 and 10 days after solutions administration to the middle ear. The resulting distortion product otoacoustic emissions were evaluated at 1.5, 2, 3, 4, 5, 6, 7, 8, 10 and 12 kHz. Statistically significant reductions in DP-gram amplitudes were noted at high frequencies (7, 8, 10, 12 kHz) in the group A at day 1 but this effect return at day 10. In group B and group C statistically significant differences were recorded for low and high frequencies (1.5, 2, 7, 8, 10, 12 kHz) according to the control group at day 1 and 10. 7.5 and 10 % povidone-iodine showed a significant ototoxic effect on day 1 and 10. But this toxic effect could not be elicited in 5 % povidone-iodine group on day 10. The present study revealed that commercially available high concentration povidone-iodine solution may cause significant ototoxic effects when applied topically through a perforated ear drum in rats. Based on results of this experiment, high concentration povidone-iodine solutions should not be used for preoperative surgical site cleansing for otologic surgery.