What Is the Evidence for Tissue Regeneration Impairment when Using a Formulation of PVP-I Antiseptic on Open Wounds?

Abstract

Wound care and the use of antiseptics has long been the subject of much debate within the health professional’s literature. This study was undertaken to determine the range of literature available on povidone-iodine (PVP-I) antiseptic use and the evidence supporting the outcomes reported. A range of articles was collected and divided into subgroups based on hierarchy of evidence and the five evidence dimensions [<citeref rid="ref001">1</citeref>]. Using the READER^® scoring tool, articles were evaluated and given a numerical award between 4 and 25 as a determinant of their quality in method, statistical analysis and outcome measures, with those scoring 12.5 or higher (from a possible 25) deemed as offering a satisfactory level of evidence. Statistical analysis on the results prior to applying the READER scoring tool found that overall 49% of articles did not support PVP-I use. However, this situation changed when the quality of evidence was limited to articles scoring >12.5. The higher-scored articles showed a 71% support for the continued use of PVP-I. The outcome of this study shows that there is reason for further debate over the use of PVP-I.

Feasibility and Clinical Applicability of Polihexanide for Treatment of Second-Degree Burn Wounds

“…Although iodine is a potent antimicrobial agent, its use in wound management is controversial due to potential systemic iodine intoxication and because some iodine formulations have been shown to impair the functioning of cells involved in normal wound healing in vitro [22] . So far, its effect on wound healing has not yet been clearly determined, but it is certainly not relevant for short-term treatment of wounds [23] . The prophylactic role of iodine in acute wounds is well supported in the literature [24] .…”

Foreign Body Penetrations of Hand and Wrist; a Retrospective Study

“…[13] On the contrary, in a review study, articles with superior level of evidence were analyzed, and it was seen that 71% of the litera- ture supports the use of PVP-I, and refutes the hypothesis that there is a negative impact on tissue regeneration. [3] Another effective and more practical alternative for wound irrigation might be tap water, especially in pediatric cases. [15] The damaged tissues can be repaired and/or primary closure can be carried out provided the irrigation procedure is adequately accomplished.…”

“…In spite of the substantial experience of clinicians on this issue, there are a significant number of articles denoting defective management strategies, such as inadequate tetanus prophylaxis, and uncertainty in basic principles such as selecting the right solution for wound irrigation. [2,3] Moreover, wounds with neglected FBs form one of the high-risk emergency medicine categories responsible for malpractice events. [4] Indeed, failure to diagnose or treat retained FBs has been reported to be the fifth leading claim against emergency physicians.…”

Management of severe head injury with brain exposure in three loggerhead sea turtles Caretta caretta

“…In addition to causing pain, many disinfectants/ antimicrobials used to control microbial contamination/infection of the wound bed also have cytotoxic effects that prevent or delay healing (Niedner 1997, Hidalgo & Dominguez 2001, Drosou et al 2003, Wilson et al 2005, Banwell 2006). The present treatment protocol for wounds supported each phase of the healing process, avoiding the need to use cytotoxic disinfectants (Noble & Kent 1992, Lloyd et al 1999, Rantala et al 2004, Paterson et al 2005, Lee et al 2006.…”