Povidone‐iodine induced post‐surgical irritant contact dermatitis localized outside of the surgical incision area. Report of 27 cases and a literature review

Abstract

Povidone-iodine-induced post-surgical dermatitis may be a severe complication after prolonged surgical procedures. As stated in the literature and based on the observation that povidone-iodine-induced contact irritant dermatitis occurred in areas of pooling or occlusion, we speculate that povidone-iodine together with occlusion were the causes of the dermatitis epidemic that occurred in our surgical setting. Povidone-iodine dermatitis is a problem that is easily preventable through the implementation of minimal routine changes to adequately dry the solution in contact with the skin.

In search of a better patch test concentration for povidone‐iodine

“…Povidone‐iodine (PVP‐I) is widely used as a skin disinfectant in wound care and preparation for surgery, most frequently as a solution containing 10% PVP‐I. Adverse reactions in terms of allergic or irritant contact dermatitis have been reported, the latter mainly occurring after prolonged occlusive skin contact under pressure . For diagnostic purposes, that is, patch testing, PVP‐I 10% aq.…”

Skin lesions over the pocket area that may mimic cardiac implantable electronic device infection: A case series

“…14,15 Interestingly, when povidone-iodine solution is misused and pooled in specific skin areas for prolonged time without drying it may cause severe contact dermatitis accompanied with erythematous plaques and skin eruption. 16 In our cases, prolonged local application of povidoneiodine over the incision area caused irritant dermatitis. Although this type of dermatitis is aseptic, local contamination may ensue and therefore antibiotic coverage is advisable in specific circumstances.…”

“…However, even a single use may rarely cause allergic reactions leading to contact dermatitis . Interestingly, when povidone‐iodine solution is misused and pooled in specific skin areas for prolonged time without drying it may cause severe contact dermatitis accompanied with erythematous plaques and skin eruption . In our cases, prolonged local application of povidone‐iodine over the incision area caused irritant dermatitis.…”

Randomized clinical trial of single skin sterilization with a povidone–iodine applicatorversusconventional skin sterilization in abdominal surgery

“…The surgical site was sterilized with a single outward spiralling movement from the centre of the abdomen in the applicator group, suggesting it is unnecessary to sterilize the same site repeatedly, as was done in the conventional group. Some consideration should also be given to the use of large volumes of povidone–iodine as this can result in chemical burns, not simply allergic reactions. In the present study, three patients in the conventional group had a skin reaction.…”

“…There is no clear evidence for the amount of disinfectant and number of swabs or balls used in existing guidelines. Large amounts of iodine disinfectant may cause adverse effects such as contact dermatitis and chemical burns, and may be unnecessarily wasteful. Povidone–iodine applicators have been approved by the Food and Drug Administration and are popular in the USA.…”