Effects of Applying Povidone-Iodine Just before Skin Closure

Abstract

Many surgeons apply povidone-iodine (PVP-I) to the skin around an incision before closing a wound to reduce wound infection rates. However, the effectiveness of this procedure has not been proven. Forty-seven cases of gastric surgery and 60 cases of colorectal surgery performed at Kanto Medical Center between July 2004 and December 2004 were randomly assigned to the group with PVP-I or the group without PVP-I. Wound infection and surgical site infection (SSI) rates were compared between these two groups. Applying PVP-I was effective in eliminating skin contamination, as cultures became negative in all cases after applying PVP-I. However, this study could not demonstrate the reduction of wound infection or SSI in the group with PVP-I, possibly because the number of cases in this study was too small to make a difference. Subcutaneous tissue contamination was considered a more important factor than skin contamination in causing wound infection.

Wound Healing Dressings and Drug Delivery Systems: A Review

“…The purpose of applying antibiotics and other antibacterials is mainly to prevent or combat infections especially for diabetic foot ulcers,147, 148 surgical and accident149 wounds where the incidence of infections can be high due to reduced resistance resulting from extreme trauma. In some cases, the delivery of certain antibiotics from paraffin based ointments such as bismuth subgallate are known to take active part in the wound healing process 150.…”

Povidone-Iodine Irrigation of Subcutaneous Tissues May Decrease Surgical Site Infections in Elective Colorectal Operations: A Systematic Review

“…Three articles were excluded for enrolling both elective and emergent abdominal operations, for which the data could not be differentiated [1, 11, 18]. Harihara et al used PVI topically on the skin rather than the subcutaneous tissue [19]. One article investigated multiple different treatments other than PVI irrigation [20] while another article was excluded for having no outcome data to report [21].…”

Meta-analysis of intraoperative povidone–iodine application to prevent surgical-site infection

“…Three of these were excluded: a congress abstract18 later published in an article included in the meta‐analysis, one lacking the required data19, and one that compared both shaving and irrigation but without detailed data20. Fifteen of the remaining studies which were graded as having a low risk of bias were included in the main analysis21–35, and nine graded as having a moderate risk of bias were included only in the sensitivity analysis36–44. Owing to the nature of irrigation, blinding of surgeons was not possible, but wound assessment was evaluated blind in seven of the 15 articles included in the main analysis.…”

“…Study characteristics and quality are summarized in Tables 1 and 2 . The 15 studies21–35 that better fulfilled methodological requirements were included in the main analysis, totalling 3281 patients: 1605 who had PVI and 1676 in the control group. Half of the studies ( n = 12) were from the UK22–26, 31, 36, 37, 39, 41–43, and five from North America27–30, 32.…”