A study showing effectiveness of surgical site skin preparation, with two step use of povidone-iodine and postoperative out come in orthopaedic patients

Authors

  • Naresh Kumar Department of Orthopaedics, Shri Shankaracharya Institute of Medical Sciences, Junwani, Bhilai, Chhattisgarh, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20194572

Keywords:

Povidone-iodine, Surgical site, Scrub, Resistance

Abstract

Background: The most common cause or source of infection in operating room is bacteria coming from inadequate cleaning of skin, surrounding environment, from the staff and from patient itself; especially geriatric with low immunity and diabetic patients. Surgical site skin infection complicates an estimated 5% of all surgeries performed in operation theater. Every measure must be taken to reduce the surgical site infection henceforth reducing the cost of treatment and morbidity of the patient. Povidone-iodine seems to be the best and cheap option.

Methods: One hundred and forty two patients who underwent orthopaedic surgery has been studied for the postoperative outcome following pre-surgical skin preparation with 2 step use of povidone iodine (PVP-I). The area to be operated is scrubbed with PVP-I scrub 7.5% and then painted with 10% PVP-I solution on operative area and wide area above and below. The paint is kept for at least 10 min or till it dry and then washed with normal saline or cleaned with sterile gauze soaked in normal saline. All postoperative patients were given intravenous antibiotics for at least 3 days. Dressing was done with PVP-I as per protocol.

Results: It has been found that out of one hundred and forty two patients studied, only 3.52% developed infection. Out of five infected patients, two were female and three with fracture were male patients.

Conclusions: PVP-I is still one of the best anti-microbial preparation widely used in orthopaedic surgery till date. It has broad spectrum anti-microbial activity and do not have any history of developing any resistance to its content.

Author Biography

Naresh Kumar, Department of Orthopaedics, Shri Shankaracharya Institute of Medical Sciences, Junwani, Bhilai, Chhattisgarh, India

Department of Orthopaedics,

Associate Professor

References

Hugo WB. A brief history of heat and chemical preservation and disinfection. J Appl Bacteriol. 1991;71:9-18.

Vallin E. Traite des desinfectants et de la desinfectantion. Paris: Masson; 1982.

Schreier H, Erdos G, Reimer K, König B, König W, Fleischer W. Molecular effects of povidone-iodine on relevant microorganisms: an electron-microscopic and biochemical study. Dermatology. 1997;195(2):111-6.

Cooper R. A review of the evidence for the use of topical antimicrobial agents in wound care. World Wide Wounds 2004. Available at: http://www.worldwidewounds.com/2004/february/Cooper/Topical-Antimicrobial-Agents.html. Accessed on 22nd July 2005.

Kramer A, Below H, Behrens-Baumann W, Müller G, Rudolph P, Reimer K. New aspects of the tolerance of the antiseptic povidone-iodine in different ex vivo models. Dermatology. 2002:204(1):86-91.

Sauerbrei A, Wutzler P. Virucidal efficacy of povidone-iodine-containing disinfectants. Letters in Appl Microbiol. 2010;51:158-63.

Zhou LH, Nahm WK, Badiavas E, Yufit T, Falanga V. Slow release iodine preparation and wound healing: in vitro effects consistent with lack of in vivo toxicity in human chronic wounds. Br J Dermatol. 2002;146(3):365-74.

Mertz PM, Alvarez OM, Smerbeck RV, Eaglstein WH. A new in vivo model for the evaluation of topical antiseptics on superficial wounds. Arch Dermatol. 1984;120:58-62.

Chang SL. Modern concept of disinfection. J Sanit Eng Div Proc ASCE. 1971;97:689.

Durani P, Leaper DJ. Povidone-iodine: use in hand disinfection, skin preparation and antiseptic irrigation. Int Wound J. 2008;5:376-87.

Phillips PL, Wolcott RD, Fletcher J, Schultz GS. Biofilms Made Easy. Wounds International. 2010;1(3):1-6.

Swenson BR, Hedrick TL, Metzger R, Bonatti H, Pruett TL, Sawyer RG. Effects of preoperative skin preparation on postoperative wound infection rates: a prospective study of 3 skin preparation protocols. Infect Control Hosp Epidemiol. 2009;30(10):964-71.

Lamme EN, Gustafsson TO, Middelkoop E. Cadexomer iodine shows stimulation of epidermal regeneration in experimental full thickness wounds. Arch Dermatol Res. 1998;290:18-24.

Jones V, Milton T. When and how to use iodine dressings. Nurs Times. 2000;96(45):2.

Gilliam DL, Nelson CL. Comparison of a one-step iodophor skin preparation versus traditional preparation in total joint surgery. Clin Orthop Relat Res. 1990;(250):258-60.

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Published

2019-10-22

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Original Research Articles