The chemical, microbiologic, and toxic characteristics of povidone-iodine solution, a commonly used antiseptic agent, are addressed in a collective review of relevant works published from 1956 to the present. Interactions of this agent with the thyroid gland and the kidneys and its toxicity at the cellular and systemic level are discussed.

Chemical and microbiologic characteristics and toxicity of povidone-iodine solutions.

https://www.archives-pmr.org/article/0003-9993(94)90117-1/pdf

Pressure ulcers: a review

Clinicians have used numerous strategies to combat wound infections, including topical and systemic administration of antibiotics, and various antiseptic agents such as hypochlorite (bleach) and hydrogen peroxide have been placed on wounds to kill bacteria or inhibit their growth. A commonly used antimicrobial agent is povidone-iodine (Betadine), a complex of iodine, the bactericidal component, with polyvinylpyrrolidone (povidone), a synthetic polymer. The most common commercial form is a 10% solution in water yielding 1% available iodine. Povidone-iodine is available as a surgical scrub or skin cleanser with a detergent base (0.75% available iodine) or in other forms. Decisions regarding choice of wound treatment involve two basic considerations: (1) how safe is the treatment, and (2) how effective is the treatment. The safety of a wound care treatment may be determined by whether the treatment retards the progress of the wound through the stages of healing (inflammatory, proliferative/reepithelializing, and remodeling). The efficacy of a wound care treatment (e.g., povidone-iodine) can be judged in vitro by its ability to kill microorganisms and in vivo by whether it decreases the rate or severity of wound infection. The task of evaluating the choice of povidone-iodine solution for treatment of wounds, especially the chronic wounds most often seen in physical therapy practice, is made complex by two factors. First, although there is a large body of research into various aspects of povidone-iodine use in wound care, the results are not always germane to the types of wound treatment most often provided by physical therapists. The relevance of in vitro studies regarding safety and effectiveness to in vivo use with patients may be limited. Much of the published research on wound healing uses animal wound models; however, the applicability of findings in animal studies to human wounds has been questioned.

/pdf/povidone-iodine-solution-in-wound-treatment-4rnbadjutn.pdf

Povidone-Iodine Solution in Wound Treatment

† We prospectively followed inpatients receiving treatment for pressure sores to identify the better of two local treatment regimens. Twenty-seven patients with 76 pressure sores received treatment with hydrocolloid dressings (HCDs) and 25 patients with 52 pressure sores received treatment with Dakin's solution (chloramine-T)-soaked wet-to-dry dressings. Thirty-eight (73%) patients initially had severe nutritional depletion. The mean serum albumin value of the pressure sore treatment groups was lower than that of an age-matched group without pressure sores. In the HCD group, 66 (86.8%) pressure sores improved compared with 36 (69.2%) pressure sores in the wet-to-dry dressings group. The HCD regimen was more efficacious even in a subgroup of patients who received inadequate nutritional support during treatment. Adequate nutritional intake during the study was associated with better healing in both local treatment groups. (Arch Dermatol1987;123:766-771)

Improved pressure sore healing with hydrocolloid dressings.

• Nephrotoxicity caused by contrast media and drugs is a frequent cause of renal failure in medical practice. However, there are only sporadic cases of renal failure caused by chemicals, foods, plants, animal venoms, and misused or illegal drugs, and standard medical textbooks are limited in the coverage given to the subject. This review provides a referenced compilation of these lesser-known nephrotoxins and gives an overview of renal failure caused by substances other than properly used medications. ( Arch Intern Med . 1990;150:505-510)

Stewart J. Friedman

Papers

Case Report Increased serum iodide concentration from iodine absorption through wounds treated topically with povidone-iodine