Dermatology
Surgery and Other Invasive Manipulations
Experiences with the Use of Povidone-Iodine-Containing Local Therapeutics in Dermatological Surgery and in the Treatment of Burns: Testing for Allergic Sensitization in Postsurgery PatientsJuhász I.Department of Dermatology, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Published online: April 27, 2002
Issue release date: 2002
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1
ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)
For additional information: https://www.karger.com/DRM
Abstract
In dermatological surgery where the lesions to be removed are very often contaminated with bacteria, local use of antiseptics that are effective against a wide range of germs is often indicated. Polyvinylpyrrolidone (povidone = PVP)-bound iodine (in Hungary marketed as Betadine®) is used successfully in our department. After excision and suture in per primam healing wounds as well as after tissue destruction in per secundam healing wounds, a thin layer of Betadine ointment on the dressing right after surgery and at dressing changes may reduce the risk of wound infection. When the defect requires split-thickness skin grafting, a combination of tulle gras and a layer of gauze soaked with 1:10 dilution of Betadine solution is suggested. In the treatment of leg ulcers, Betadine is used for cleansing and for impregnating the gauze on top of the tulle gras layer both in the debridement and in the epithelization phases. PVP-I is beneficial on burn wounds due to its effect reducing bacterial colony counts. Its use is advised for superficial (grades 1 and 2a) burns as well as surgical debridement of deep burns or temporary xenograft or definitive autograft coverage of these wounds. After treating a large number of patients with Betadine, a statement can be made: despite its theoretical risk, no cytostatic effect is seen in the clinical setting. No allergy towards Betadine was observed among the author’s patients over several years of its use. Fifty patients previously treated with PVP-I were challenged with epicutaneous patch testing, and no sensitization was found. An account is made on the adverse effects attributed to Betadine found in the scientific literature, and its use with regard to the proper indications is suggested.
© 2002 S. Karger AG, Basel
Related Articles:
References
-
Davaine MC: Recherches sur le traitement des maladies charbonneuses chez l’homme. Bull Acad Natl Med Paris 1880;9:757.
- Stahl-Bayliss CM, Grandy RP, Fitzmartin RD, Chelle C, Oshlack B, Goldenheim PD: The comparative efficacy and safety of 5% povidone-iodine cream for topical antisepsis. Ostomy Wound Manag 1990;31:40–49.
-
Harvey SC: Antiseptics and disinfectants; in Hardman JG, Limbird LE, Goodman Gilman A (eds): Goodman and Gilman’s Pharmacological Basis of Therapeutics. New York, Macmillan Press, 1980, p 973.
-
Hieholzer G: Topische Infektionstherapie und Prophylaxe. Stuttgart, Thieme, 1996, p 144.
-
Hunyadi J, Bakos N, Mészáros CS, Erdei I: The importance of allergy to Peruvian balsam today. Congr Proc Sci Conf TAIM Found, Debrecen, 1995, pp 215–218.
- Moghadam BK, Drisko CL, Gier RE: Chlorhexidine mouthwash-induced fixed drug eruption: Case report and review of the literature. Oral Surg Oral Med Oral Pathol 1991;71:431–434.
- Visser LE, Veeger JH, Roovers MH, Chan E, Stricker BH: Anaphylaxis caused by chlorhexidine following cystoscopy or urethral catheterization. Ned Tijdschr Geneeskd 1994;138:778–780.
-
Campistol JM, Abad C, Nogue S, Bertran A: Acute renal failure in a patient treated by continuous povidone-iodine mediastinal irrigation. J Cardiovasc Surg Torino 1988;29:410–412.
-
Zec N, Donovan JW, Aufiero TX, Kincaid RL, Demers LM: Seizures in a patient treated with continuous povidone-iodine mediastinal irrigation (letter). N Engl J Med 1992;326:1784.
- Keating JP, Neill M, Hill GL: Sclerosing encapsulating peritonitis after intraperitoneal use of povidone iodine. Aust NZ J Surg 1997;67:742–744.
- Goetz A, Muder RR: Pseudomonas aeruginosa infections associated with use of povidone-iodine in patients receiving continuous ambulatory peritoneal dialysis. Infect Control Hosp Epidemiol 1989;10:447–450.
- Panlilio AL, Beck-Sague CM, Siegel JD, Anderson RL, Yetts SY, Clark NC, Duer PN, Thomassen KA, Vess RW, Hill BC: Infections and pseudoinfections due to povidone-iodine solution contaminated with Pseudomonas cepacia. Clin Infect Dis 1992;14:1078–1083.
-
Hauben M: Seizures after povidone-iodine mediastinal irrigation (letter; comment). N Engl J Med 1993;328:355.
External Resources
- Oberg MS, Lindsey D: Do not put hydrogen peroxide or povidone iodine into wounds! (editorial). Am J Dis Child 1987;141:27–28.
- Damour O, Hua SZ, Lasne F, Villain M, Rousselle P, Collombel C: Cytotoxicity evaluation of antiseptics and antibiotics on cultured human fibroblasts and keratinocytes. Burns 1992;18:479–485.
-
Niedner R: Cytotoxicity and sensitization of povidone-iodine and other frequently used anti-infective agents. Dermatology 1997;195 (suppl 2):89–92.
- Linder N, Davidovitch N, Reichman B, Kuint J, Hegesh J, Lubin D, Sack J: Topical iodine-containing antiseptics and subclinical hypothyroidism in preterm infants. J Pediatr 1997;131:434–439.
- Brown RS, Bloomfield S, Bednarek FJ, Mitchell ML, Braverman LE: Routine skin cleansing with povidone-iodine is not a common cause of transient neonatal hypothyroidism in North America: A prospective controlled study. Thyroid 1997;7:395–400.
- Shetty KR, Duthie EH Jr: Thyrotoxicosis induced by topical iodine application. Arch Intern Med 1990;150:2400–2401.
-
Steen M: Review of the use of povidone-iodine (PVP-I) in the treatment of burns. Postgrad Med J 1993;69(suppl 3):S84–92.
- Nakano S, Uchiyama A, Ueyama H, Nishimura M, Tashiro C, Azuma T: Chemical burn caused by povidone-iodine. Masui 1991;40:812–815.
-
Okano M: Irritant contact dermatitis caused by povidone-iodine (letter). J Am Acad Dermatol 1989;20:860.
- Ancona A, Suarez-de-la-Torre R, Macotela E: Allergic contact dermatitis from povidone-iodine. Contact Dermatitis 1985;13:66–68.
-
Lopez-Saez MP, de Barrio M, Zubeldia JM, Prieto A, Olalde S, Baeza ML: Acute IgE-mediated generalized urticaria-angioedema after topical application of povidone-iodine. Allergol Immunopathol Madr 1998;26:23–26.
- Tosti A, Vincenzi C, Bardazzi F, Mariani R: Allergic contact dermatitis due to povidone-iodine. Contact Dermatitis 1990;23:197–198.
- Pohl-Markl H, Neumann R: Polyvinylpyrrolidon-Jod (PVP-Jod) – Seine Bedeutung für die Dermatologie. Z Hautkr 1988;63:1009–1015.
- Kunze J, Kaiser HJ, Petres J: Relevance of an iodine allergy to commercial polyvidone-iodine preparations. Z Hautkr 1983;58:255–261.
Article / Publication Details
Published online: April 27, 2002
Issue release date: 2002
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1
ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)
For additional information: https://www.karger.com/DRM
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
