Povidone-iodine in wound healing and prevention of wound infections
Keywords:
Povidone-iodine, PVP-I, Antiseptic, Antimicrobial, Wound infection
Abstract
The wound infections caused by bacteria and fungi are a significant problem in healthcare. Therefore, an effective treatment and prevention seems to be essential. Povidone-iodine is one of the commercial antimicrobial agents used for skin disinfection, in surgery and for local anti-infective treatment. The broad activity spectrum of this compound includes numerous species of Gram-positive and Gram-negative bacteria, mycobacteria, fungi, protozoa and viruses. Povidone-iodine is recommended for acute wounds as well as lacerations, bruises and deep wounds due to its good tissue penetration.
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References
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5. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev. 1999; 12: 147-179.
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7. Reimer K, Wichelhaus TA, Schäfer V, Rudolph P, Kramer A, Wutzler P, Ganzer D, Fleischer W. Antimicrobial effectiveness of povidone-iodine and consequences for new application areas. Dermatology. 2002; 204: 114-120.
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9. Kampf G. Antiseptic stewardship: biocide resistance and clinical implications. Springer International Publishing, 2018.
10. National Center for Biotechnology Information. PubChem Database. Povidone iodine, CID=410087, https://pubchem.ncbi.nlm.nih.gov/compound/Povidone-iodine (accessed on May 13, 2020)
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12. Koerner JC, George MJ, Meyer DR, Rosco MG, Habib MM. Povidone-iodine concentration and dosing in cataract surgery. Surv Ophthalmol. 2018; 63: 862-868.
13. Burks RI. Povidone-iodine solution in wound treatment. Phys Ther. 1998; 78: 212-218.
14. Rackur H. New aspects of mechanism of action of povidone-iodine. J Hosp Infect. 1985; 6: 13-23.
15. 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. DRM. 1997; 195: 111-116.
16. König B, Reimer K, Fleischer W, König W. Effects of betaisodona on parameters of host defense. Dermatology. 1997; 195: 42-48.
17. Eggers M. Infectious disease management and control with povidone iodine. Infect Dis Ther. 2019; 8: 581-593.
18. Eggers M, Koburger-Janssen T, Eickmann M, Zorn J. In vitro bactericidal and virucidal efficacy of povidone-iodine gargle/mouthwash against respiratory and oral tract pathogens. Infect Dis Ther. 2018; 7: 249-259.
19. Block C, Robenshtok E, Simhon A, Shapiro M. Evaluation of chlorhexidine and povidone iodine activity against methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecalis using a surface test. J Hosp Infect. 2000; 46: 147-152.
20. Kunisada T, Yamada K, Oda S, Hara O. Investigation on the efficacy of povidone-iodine against antiseptic-resistant species. Dermatology. 1997; 195: 14-18.
21. Wichelhaus TA, Schäfer V, Hunfeld KP, Reimer K, Fleischer W, Brade V. Antibacterial effectiveness of povidone-iodine (Betaisodona) against highly resistance gram positive organisms. Zentralbl Hyg Umweltmed. 1998; 200: 435-442.
22. Ghaddara HA, Kumar JA, Cadnum JL, Ng-Wong YK, Donskey CJ. Efficacy of a povidone iodine preparation in reducing nasal methicillin-resistant Staphylococcus aureus in colonized patients. Am J Infect Control. 2020; 48: 456-459.
23. Tsuda S, Soutome S, Hayashida S, Funahara M, Yanamoto S, Umeda M. Topical povidone iodine inhibits bacterial growth in the oral cavity of patients on mechanical ventilation: a randomized controlled study. BMC Oral Health. 2020; 20: 62.
24. Kean R, McKloud E, Townsend EM, Sherry L, Delaney C, Jones BL, et al. The comparative efficacy of antiseptics against Candida auris biofilms. Int J Antimicrob Agents. 2018; 52: 673-677.
25. Koburger T, Hubner N-O, Braun M, Siebert J, Kramer A. Standardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidine dihydrochloride, polyhexanide and chlorhexidine digluconate. J Antimicrob Chemother. 2010; 65: 1712-1719.
26. Lacey RW. Antibacterial activity of povidone iodine towards non-sporing bacteria. J Appl Bacteriol. 1979; 46: 443-449.
27. Oates A, Lindsay S, Mistry H, Ortega F, McBain AJ. Modelling antisepsis using defined populations of facultative and anaerobic wound pathogens grown in a basally perfused biofilm model. Biofouling. 2018; 34: 507-518.
28. Reynolds MM, Greenwood-Quaintance KE, Patel R, Pulido JS. Selected antimicrobial activity of topical ophthalmic anesthetics. Transl Vis Sci Technol. 2016; 5(4): 2.
29. Herruzo-Cabrera R, Garcia-Torres V, Rey-Calero J, Vizcaino-Alcaide MJ. Evaluation of the penetration strength, bactericidal efficacy and spectrum of action of several antimicrobial creams against isolated microorganisms in a burn centre. Burns. 1992; 18: 39-44.
30. Chen Y, Liao K, Huang Y,Guo P, Huang H, Wu Z, Liu M. Determining the susceptibility of carbapenem resistant Klebsiella pneumoniae and Escherichia coli strains against common disinfectants at a tertiary hospital in China. BMC Infect Dis. 2020; 20: 88.
31. Párducz L, Eszik I, Wagner G, Burián K, Endrész V, Virok DP. Impact of antiseptics on Chlamydia trachomatis growth. Lett Appl Microbiol. 2016; 63: 260-267.
32. Kondo S, Tabe Y, Yamada T, Misawa S, Oguri T, Ohsaka A, Miida T. Comparison of antifungal activities of gentian violet and povidone-iodine against clinical isolates of Candida species and other yeasts: a framework to establish topical disinfectant activities. Mycopathologia. 2012; 173: 21-25.
33. Traboulsi RS, Mukherjee PK, Ghannoum MA. In vitro activity of inexpensive topical alternatives against Candida spp. isolated from the oral cavity of HIV-infected patients. Int J Antimicrob Agents. 2008; 31: 272-276.
34. Goswami K, Austin MS. Intraoperative povidone-iodine irrigation for infection prevention. Arthroplast Today. 2019; 5: 306-308.
35. Eggers M, Koburger-Janssen T, Ward LS, Newby C, Müller S. Bactericidal and virucidal activity of povidone-iodine and chlorhexidine gluconate cleansers in an in vivo hand hygiene clinical simulation study. Infect Dis Ther. 2018; 7: 235-247.
36. Durani P, Leaper D. Povidone–iodine: use in hand disinfection, skin preparation and antiseptic irrigation. Int Wound J. 2008; 5(3): 376-387.
37. Kambara Y, Hiramatsu K, Kato T, Sibata Y, Yoshihara M, Aoba T, et al. Randomized clinical trial of single skin sterilization with a povidone–iodine applicator versus conventional skin sterilization in abdominal surgery. BJS Open. 2019; 3: 282-287.
38. Chen S, Chen JW, Guo B, Xu CC. Preoperative antisepsis with chlorhexidine versus povidone-iodine for the prevention of surgical site infection: a systematic review and meta-analysis. World J Surg. 2020; 44: 1412-1424.
39. Ghobrial GM, Wang MY, Green BA, Levene HB, Manzano G, Vanni S, et al. Preoperative skin antisepsis with chlorhexidine gluconate versus povidone-iodine: a prospective analysis of 6959 consecutive spinal surgery patients. J Neurosurg Spine. 2018; 28: 209-214.
40. Kramer A, Dissemond J, Kim S, Willy C, Mayer D, Papke R, et al. Consensus on wound antisepsis: update 2018. Skin Pharmacol Physiol. 2018; 31(1): 28-58.
41. Daróczy J. Quality control in chronic wound management: the role of local povidone-iodine (Betadine®) therapy. Dermatology. 2006; 212: 82-87.
42. Gwak HC, Han SH, Lee J, et al. Efficacy of a povidone‐iodine foam dressing (Betafoam) on diabetic foot ulcer. Int Wound J. 2020; 17: 91-99.
43. Ritter B, Herlyn PKE, Mittlmeier T, Herlyn A. Preoperative skin antisepsis using chlorhexidine may reduce surgical wound infections in lower limb trauma surgery when compared to povidone-iodine - a prospective randomized trial. Am J Infect Control. 2020; 48: 167-172.
44. Roeckner JT, Sanchez-Ramos L, Mitta M, Kovacs A, Kaunitz AM. Povidone-iodine 1% is the most effective vaginal antiseptic for preventing post-cesarean endometritis: A systematic review and network meta-analysis. Am J Obstet Gynecol. 2019; 221: 261.e1-261.e20.
45. Haas DM, Morgan S, Contreras K, Enders S. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev. 2018; 7: CD007892.
46. Arslan IB, Genc S, Kayhan BC, Gumussoy M, Ozel G, Cukurova I. Bacterial change in external auditory canal upon antisepsis with povidone-iodine during tympanoplasty. Eur Arch Otorhinolaryngol. 2015; 272: 551-555.
47. Bordin P. Corneal ulcer treated with 0.66% nanoemulsion povidone-iodine: a case report. Am J Case Rep. 2020; 21: e919822-1–e919822-6.
48. Nayyar R, Dadhwal R, Kapil A, Pandey RM, Dogra P. Urethral instillation of povidone-iodine reduces post-cystoscopy urinary tract infection in males: a randomized controlled trial. Sci Rep. 2020; 10: 3585.
49. Suzuki T, Kataoka H, Ida T, Mikuniya T, Suzuki T, Kamachi K. Bactericidal activity of topical antiseptics and their gargles against Bordetella pertussis. J Infect Chemother. 2012; 18: 272-275.
50. Karpiński TM. Efficacy of octenidine against Pseudomonas aeruginosa strains. Eur J Biol Res. 2019; 9: 135-140.
51. Nobukuni K, Hayakawa N, Namba R, Ihara Y. The influence of long-term treatment with povidone-iodine on thyroid function. Dermatology. 1997; 195: 69-72.
2. Rahim K, Saleha S, Zhu X, Huo L, Basit A, Franco OL. Bacterial contribution in chronicity of wounds. Microb Ecol. 2017; 73: 710-721.
3. Karpiński TM. Zastosowanie antyseptyków w leczeniu ran. The use of antiseptics in the treatment of wounds. Chirurgia po Dyplomie. 2020 [in press].
4. Sopata M, Jawień A, Mrozikiewicz-Rakowska B, Augusewicz Z, Bakowska M, Samson I, et al. Wytyczne postępowania miejscowego w ranach niezakażonych, zagrożonych infekcją oraz zakażonych – przegląd dostępnych substancji przeciwdrobnoustrojowych stosowanych w leczeniu ran. Zalecenia Polskiego Towarzystwa Leczenia Ran. Leczenie Ran. 2020; 17: 1-21.
5. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev. 1999; 12: 147-179.
6. Zamora JL. Chemical and microbiologic characteristics and toxicity of povidone-iodine solutions. Am J Surg. 1986; 151: 400-406.
7. Reimer K, Wichelhaus TA, Schäfer V, Rudolph P, Kramer A, Wutzler P, Ganzer D, Fleischer W. Antimicrobial effectiveness of povidone-iodine and consequences for new application areas. Dermatology. 2002; 204: 114-120.
8. Bigliardi PL, Alsagoff SAL, El-Kafrawi HY, Pyon J-K, Wa CTC, Villa MA. Povidone iodine in wound healing: A review of current concepts and practices. Int J Surg. 2017; 44: 260-268.
9. Kampf G. Antiseptic stewardship: biocide resistance and clinical implications. Springer International Publishing, 2018.
10. National Center for Biotechnology Information. PubChem Database. Povidone iodine, CID=410087, https://pubchem.ncbi.nlm.nih.gov/compound/Povidone-iodine (accessed on May 13, 2020)
11. Kanagalingam J, Feliciano R, Hah JH, Labib H, Le TA, Lin J-C. Practical use of povidone-iodine antiseptic in the maintenance of oral health and in the prevention and treatment of common oropharyngeal infections. Int J Clin Pract. 2015; 69: 1247-1256.
12. Koerner JC, George MJ, Meyer DR, Rosco MG, Habib MM. Povidone-iodine concentration and dosing in cataract surgery. Surv Ophthalmol. 2018; 63: 862-868.
13. Burks RI. Povidone-iodine solution in wound treatment. Phys Ther. 1998; 78: 212-218.
14. Rackur H. New aspects of mechanism of action of povidone-iodine. J Hosp Infect. 1985; 6: 13-23.
15. 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. DRM. 1997; 195: 111-116.
16. König B, Reimer K, Fleischer W, König W. Effects of betaisodona on parameters of host defense. Dermatology. 1997; 195: 42-48.
17. Eggers M. Infectious disease management and control with povidone iodine. Infect Dis Ther. 2019; 8: 581-593.
18. Eggers M, Koburger-Janssen T, Eickmann M, Zorn J. In vitro bactericidal and virucidal efficacy of povidone-iodine gargle/mouthwash against respiratory and oral tract pathogens. Infect Dis Ther. 2018; 7: 249-259.
19. Block C, Robenshtok E, Simhon A, Shapiro M. Evaluation of chlorhexidine and povidone iodine activity against methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecalis using a surface test. J Hosp Infect. 2000; 46: 147-152.
20. Kunisada T, Yamada K, Oda S, Hara O. Investigation on the efficacy of povidone-iodine against antiseptic-resistant species. Dermatology. 1997; 195: 14-18.
21. Wichelhaus TA, Schäfer V, Hunfeld KP, Reimer K, Fleischer W, Brade V. Antibacterial effectiveness of povidone-iodine (Betaisodona) against highly resistance gram positive organisms. Zentralbl Hyg Umweltmed. 1998; 200: 435-442.
22. Ghaddara HA, Kumar JA, Cadnum JL, Ng-Wong YK, Donskey CJ. Efficacy of a povidone iodine preparation in reducing nasal methicillin-resistant Staphylococcus aureus in colonized patients. Am J Infect Control. 2020; 48: 456-459.
23. Tsuda S, Soutome S, Hayashida S, Funahara M, Yanamoto S, Umeda M. Topical povidone iodine inhibits bacterial growth in the oral cavity of patients on mechanical ventilation: a randomized controlled study. BMC Oral Health. 2020; 20: 62.
24. Kean R, McKloud E, Townsend EM, Sherry L, Delaney C, Jones BL, et al. The comparative efficacy of antiseptics against Candida auris biofilms. Int J Antimicrob Agents. 2018; 52: 673-677.
25. Koburger T, Hubner N-O, Braun M, Siebert J, Kramer A. Standardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidine dihydrochloride, polyhexanide and chlorhexidine digluconate. J Antimicrob Chemother. 2010; 65: 1712-1719.
26. Lacey RW. Antibacterial activity of povidone iodine towards non-sporing bacteria. J Appl Bacteriol. 1979; 46: 443-449.
27. Oates A, Lindsay S, Mistry H, Ortega F, McBain AJ. Modelling antisepsis using defined populations of facultative and anaerobic wound pathogens grown in a basally perfused biofilm model. Biofouling. 2018; 34: 507-518.
28. Reynolds MM, Greenwood-Quaintance KE, Patel R, Pulido JS. Selected antimicrobial activity of topical ophthalmic anesthetics. Transl Vis Sci Technol. 2016; 5(4): 2.
29. Herruzo-Cabrera R, Garcia-Torres V, Rey-Calero J, Vizcaino-Alcaide MJ. Evaluation of the penetration strength, bactericidal efficacy and spectrum of action of several antimicrobial creams against isolated microorganisms in a burn centre. Burns. 1992; 18: 39-44.
30. Chen Y, Liao K, Huang Y,Guo P, Huang H, Wu Z, Liu M. Determining the susceptibility of carbapenem resistant Klebsiella pneumoniae and Escherichia coli strains against common disinfectants at a tertiary hospital in China. BMC Infect Dis. 2020; 20: 88.
31. Párducz L, Eszik I, Wagner G, Burián K, Endrész V, Virok DP. Impact of antiseptics on Chlamydia trachomatis growth. Lett Appl Microbiol. 2016; 63: 260-267.
32. Kondo S, Tabe Y, Yamada T, Misawa S, Oguri T, Ohsaka A, Miida T. Comparison of antifungal activities of gentian violet and povidone-iodine against clinical isolates of Candida species and other yeasts: a framework to establish topical disinfectant activities. Mycopathologia. 2012; 173: 21-25.
33. Traboulsi RS, Mukherjee PK, Ghannoum MA. In vitro activity of inexpensive topical alternatives against Candida spp. isolated from the oral cavity of HIV-infected patients. Int J Antimicrob Agents. 2008; 31: 272-276.
34. Goswami K, Austin MS. Intraoperative povidone-iodine irrigation for infection prevention. Arthroplast Today. 2019; 5: 306-308.
35. Eggers M, Koburger-Janssen T, Ward LS, Newby C, Müller S. Bactericidal and virucidal activity of povidone-iodine and chlorhexidine gluconate cleansers in an in vivo hand hygiene clinical simulation study. Infect Dis Ther. 2018; 7: 235-247.
36. Durani P, Leaper D. Povidone–iodine: use in hand disinfection, skin preparation and antiseptic irrigation. Int Wound J. 2008; 5(3): 376-387.
37. Kambara Y, Hiramatsu K, Kato T, Sibata Y, Yoshihara M, Aoba T, et al. Randomized clinical trial of single skin sterilization with a povidone–iodine applicator versus conventional skin sterilization in abdominal surgery. BJS Open. 2019; 3: 282-287.
38. Chen S, Chen JW, Guo B, Xu CC. Preoperative antisepsis with chlorhexidine versus povidone-iodine for the prevention of surgical site infection: a systematic review and meta-analysis. World J Surg. 2020; 44: 1412-1424.
39. Ghobrial GM, Wang MY, Green BA, Levene HB, Manzano G, Vanni S, et al. Preoperative skin antisepsis with chlorhexidine gluconate versus povidone-iodine: a prospective analysis of 6959 consecutive spinal surgery patients. J Neurosurg Spine. 2018; 28: 209-214.
40. Kramer A, Dissemond J, Kim S, Willy C, Mayer D, Papke R, et al. Consensus on wound antisepsis: update 2018. Skin Pharmacol Physiol. 2018; 31(1): 28-58.
41. Daróczy J. Quality control in chronic wound management: the role of local povidone-iodine (Betadine®) therapy. Dermatology. 2006; 212: 82-87.
42. Gwak HC, Han SH, Lee J, et al. Efficacy of a povidone‐iodine foam dressing (Betafoam) on diabetic foot ulcer. Int Wound J. 2020; 17: 91-99.
43. Ritter B, Herlyn PKE, Mittlmeier T, Herlyn A. Preoperative skin antisepsis using chlorhexidine may reduce surgical wound infections in lower limb trauma surgery when compared to povidone-iodine - a prospective randomized trial. Am J Infect Control. 2020; 48: 167-172.
44. Roeckner JT, Sanchez-Ramos L, Mitta M, Kovacs A, Kaunitz AM. Povidone-iodine 1% is the most effective vaginal antiseptic for preventing post-cesarean endometritis: A systematic review and network meta-analysis. Am J Obstet Gynecol. 2019; 221: 261.e1-261.e20.
45. Haas DM, Morgan S, Contreras K, Enders S. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev. 2018; 7: CD007892.
46. Arslan IB, Genc S, Kayhan BC, Gumussoy M, Ozel G, Cukurova I. Bacterial change in external auditory canal upon antisepsis with povidone-iodine during tympanoplasty. Eur Arch Otorhinolaryngol. 2015; 272: 551-555.
47. Bordin P. Corneal ulcer treated with 0.66% nanoemulsion povidone-iodine: a case report. Am J Case Rep. 2020; 21: e919822-1–e919822-6.
48. Nayyar R, Dadhwal R, Kapil A, Pandey RM, Dogra P. Urethral instillation of povidone-iodine reduces post-cystoscopy urinary tract infection in males: a randomized controlled trial. Sci Rep. 2020; 10: 3585.
49. Suzuki T, Kataoka H, Ida T, Mikuniya T, Suzuki T, Kamachi K. Bactericidal activity of topical antiseptics and their gargles against Bordetella pertussis. J Infect Chemother. 2012; 18: 272-275.
50. Karpiński TM. Efficacy of octenidine against Pseudomonas aeruginosa strains. Eur J Biol Res. 2019; 9: 135-140.
51. Nobukuni K, Hayakawa N, Namba R, Ihara Y. The influence of long-term treatment with povidone-iodine on thyroid function. Dermatology. 1997; 195: 69-72.
Published
2020-06-06
How to Cite
(1)
Gmur, M.; Karpiński, T. Povidone-Iodine in Wound Healing and Prevention of Wound Infections. European Journal of Biological Research 2020, 10, 232-239.
Section
Review Articles
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