povidone-iodine and iopromide

Contrast-medium extravasation injuries may be self-limited to catastrophic. Adequate prophylactic measures are enforced when risk factors for extravasation are present, and prompt treatment can avoid serious complications.. To describe the squeeze maneuver, an effective method for the treatment of symptomatic contrast-medium extravasation.. Over a 3-month period, eight patients with >50 ml contrast-medium extravasation resulting in vascular compromise of the fingers were managed with the squeeze maneuver as follows. The intravenous catheter used for contrast-medium injection was removed, and the skin around the insertion site was cleaned with povidone-iodine. An 18-gauge needle was then used to puncture five to eight openings near the catheter insertion site as deeply as possible. We then began squeezing from the periphery of the swelling toward the needle holes. As the contrast medium drained, it was swabbed away with iodine-soaked cotton swabs.. In all eight patients, the maneuver was successful with immediate resolution of the vascular compromise.. The squeeze maneuver provides an easy way to manage radiological contrast-medium extravasation and can be performed immediately in the CT suite.

Topics: Aged; Aged, 80 and over; Anti-Infective Agents, Local; Contrast Media; Drainage; Extravasation of Diagnostic and Therapeutic Materials; Female; Forearm; Humans; Iohexol; Male; Massage; Middle Aged; Needles; Povidone-Iodine; Punctures; Radiography; Treatment Outcome

Severe wound infection after open-heart surgery is a potentially life-threatening complication, which is mostly treated by re-operation with debridement, and insertion of closed irrigation drainage. Until now there is no consensus about the appropriate duration of irrigation therapy. Since the retrosternal irrigation cavity is likely to become continually smaller as the infection heals, this study was intended to answer the question, as to whether this process can be made visible by the use of contrast media radiography, and whether this information could be used to determine when an irrigation therapy can safely be discontinued. In 1997, 34 patients suffered from sternal wound healing disturbances which required re-operation at our institution (incidence = 0.97%). During the re-operation, a closed retrosternal irrigation drainage was inserted. Of the 34 patients contrast media radiography examinations were carried out on the first, 4th and 12th postoperative day (POD), which consisted of an antero-posterior x-ray of the chest after contrast media injection through each inlet tube. At POD 4 and 12 in the majority of cases, the retrosternal irrigation cavity became smaller when compared with the previous x-ray examination. Only in three of the non-survivors there was a huge irrigation cavity visible at the 12th POD, which sometimes even included the pleural cavity. We conclude that in patients with mediastinitis treated by insertion of a closed irrigation drainage, the retrosternally irrigated cavity seems to become smaller over the therapeutic course of treatment. This process can be visualized by contrast media radiography. Results from this examination should be included in decision making about the best time for discontinuation of the irrigation therapy.

Topics: Anti-Infective Agents, Local; Aortic Valve; Contrast Media; Coronary Artery Bypass; Debridement; Decision Making; Drainage; Follow-Up Studies; Heart Valve Prosthesis Implantation; Humans; Iohexol; Mediastinitis; Middle Aged; Pleura; Povidone-Iodine; Radiography, Thoracic; Reoperation; Sternum; Surgical Wound Dehiscence; Surgical Wound Infection; Therapeutic Irrigation