povidone-iodine and Breast-Neoplasms

Malignant pleural effusions continue to be a common problem in patients with metastatic disease, leading to a significant reduction in quality of life with progressive dyspnea, dry cough, chest pain and reduced physical activity. This study was conducted to compare the efficacy, safety, and outcome of Talc Powder Pleurodesis (TPP) with Povidone-iodine Pleurodesis (PIP) through a chest drain as a palliative preventive treatment of recurrent malignant pleural effusion.. A total of 39 neoplastic patients with recurrent malignant pleural effusion were enrolled in a prospective randomized trial. Twenty-one patients received Talc pleurodesis (group A), and eighteen patients (group B) received Povidone-iodine pleurodesis. The continuous variables were expressed as mean values ± standard deviation (SD) and compared using the unpaired t-test. The discrete variables were expressed as percentage and compared using the chi-square test (χ(2)) test. p-values of less than 0.05 were considered significant.. Our study included 11 males and 28 females, the mean age was (71.0 ± 5.0) years for group A and (70.9 ± 5.1) years for group B (non-significant). Post-procedure analgesic requirements were recorded in both groups. Four patients in each group had fever (>38°C) within 48 hours of the procedure. Both groups achieved good symptomatic relief. There were no in-hospital deaths. The mean post-procedure hospital stay was (4.7 ± 1.2) days for group A and (4.2 ± 1.0) for group B (non-significant). At follow-up recurrence of significant pleural effusion requiring intervention was noted in four and five patients in group A and group B, respectively (non-significant difference).. Povidone-iodine pleurodesis can be considered as a good alternative to Talc pleurodesis for recurrent malignant pleural effusion. The drug is available, cost effective, safe and can be administered through an intercostal drain and repeated if necessary.

Topics: Aged; Aged, 80 and over; Breast Neoplasms; Chest Tubes; Chi-Square Distribution; Dyspnea; Female; Humans; Length of Stay; Lung Neoplasms; Male; Palliative Care; Pleural Effusion, Malignant; Pleurodesis; Povidone-Iodine; Prospective Studies; Quality of Life; Talc; Thoracentesis; Treatment Outcome

To compare the efficacy, safety, and outcome of thoracoscopic talc poudrage (TTP) versus povidone-iodine pleurodesis (PIP) through a thoracostomy tube as a palliative treatment of pleural effusion due to metastatic breast carcinoma (MBC).. A total of 42 MBC patients were prospectively enrolled in a randomized controlled trial. Twenty-two patients received TTP (group A), whereas 20 patients (group B) underwent pleurodesis by instilling povidone-iodine through a thoracostomy tube, as a bedside procedure.. The mean age was 48.2 ± 9.9 (range: 29-64) years and 50.2 ± 7 (range: 32-62) years for groups A and B, respectively (p=ns). At presentation, all patients had moderate to severe dyspnea, New York Heart Association (NYHA)>II and Medical Research Council (MRC) dyspnea scale 3-5. Morbidity in both groups was low. Post-procedure analgesic requirements due to severe pleuritic chest pain were higher in group A (18% vs 0%, p=0.2). Four patients in group A (18%) and one in group B (5%) were febrile (>38°C) within 48 h of the procedure. Both groups achieved good symptom control, with improvement in MRC dyspnea scale (1-3). There were no in-hospital deaths. Post-procedure hospital stay was lower in group B (p=0.009). The mean progression-free interval was 6.6 (range 3-15) months. At follow-up (mean: 22.6 (range: 8-48) months), recurrence of significant pleural effusion requiring intervention was noted in two and three patients in group A and group B, respectively (p=ns).. Povidone-iodine can be considered as a good alternative to TTP to ensure effective pleurodesis for patients with malignant pleural effusion due to MBC. The drug is available, cost effective and safe, can be given through a thoracostomy tube and can be repeated if necessary.

Topics: Adult; Anesthesia, General; Breast Neoplasms; Dyspnea; Female; Humans; Insufflation; Middle Aged; Palliative Care; Pleural Effusion, Malignant; Pleurodesis; Povidone-Iodine; Prospective Studies; Recurrence; Talc; Thoracic Surgery, Video-Assisted; Treatment Outcome

Triple-antibiotic irrigation of breast implant pockets is a mainstay of infection prophylaxis in breast reconstruction and augmentation. The recall of bacitracin for injection due to risk of anaphylaxis and nephrotoxicity in January 2020, a staple component of the irrigation solution, has raised concern for worsened postoperative sequelae. This study aimed to investigate pre- and post-recall implant-based breast surgery to analyze the impact of bacitracin in irrigation solutions on infection rates.. All implant-based breast reconstruction or augmentation surgeries from January 2019 to February 2021 were retrospectively reviewed. In a regression discontinuity study design, patients were divided into pre- and post-recall groups. Patient demographics, surgical details, and outcomes including infection rates were collected. Differences in complication rates were compared between groups and with surgical and patient factors.. Despite the recent recall of bacitracin from inclusion in breast pocket irrigation solutions, our study demonstrated no detrimental impact on immediate complication rates. This shift in irrigation protocols calls for additional investigations into optimizing antibiotic combinations in solution, as bacitracin is no longer a viable option, to improve surgical outcomes and long-term benefits.

Topics: Anti-Bacterial Agents; Bacitracin; Breast Implants; Breast Neoplasms; Cefazolin; Female; Gentamicins; Humans; Povidone-Iodine; Retrospective Studies; Treatment Outcome

Topics: Animals; Biomedical Research; Bleomycin; Breast Neoplasms; Dose-Response Relationship, Drug; Female; Humans; Lung Neoplasms; Mesothelioma; Pleural Effusion, Malignant; Pleurodesis; Povidone-Iodine; Rabbits; Talc; Tetracycline

Wound healing represents a dynamic process of increasing scientific interest, especially with the detection of the different growth factors. Economic aspects are also of importance in the investigation of substances used for wound healing. In Germany 25% of all patients (ca. 1 million) with severe chronic venous insufficiency have crural ulcers. The influence of bacterial infection of crural ulcers is controversial. There is no doubt that the quantity of bacteria is of importance. Local antibiotic treatment is difficult, as most of the substances used are known to inhibit wound healing. In vivo and in vitro investigations showed, that chiniofon-containing antiseptic has a bacteriostatic function. Additionally it was shown, using cultures of fibroblasts, that chiniofon-containing antiseptic does not inhibit the growth of fibroblasts, whereas PVP-iodine solution, a widely used antiseptic, clearly reduces the growth of fibroblasts. The good clinical results in the treatment of acute and chronic radiation damage indicate that chiniofon-containing antiseptic may have antiflammatory activity.

Topics: Administration, Topical; Adult; Aged; Animals; Breast Neoplasms; Cell Division; DNA Replication; Dose-Response Relationship, Drug; Female; Humans; In Vitro Techniques; L Cells; Male; Mice; Microbial Sensitivity Tests; Middle Aged; Mouth Mucosa; Otorhinolaryngologic Neoplasms; Povidone-Iodine; Radiodermatitis; Skin; Stomatitis; Superinfection; Varicose Ulcer; Wound Healing

The ability of commonly used operative lavage solutions to destroy breast cancer cells was investigated. The cytotoxicity of solutions of Savlon, noxythiolin, povidone iodine, hydrogen peroxide, bleomycin and water on two human breast cancer cell lines was measured in vitro. Viable cells were determined by ability to exclude trypan blue. Results have been analysed with standard non-parametric tests and demonstrate that all solutions tested significantly (P less than 0.01) reduced the number of viable cells recovered when compared with a control solution of phosphate buffered saline. Solutions of Savlon, 2.5% noxythiolin and povidone iodine were more effective than the other agents in reducing the number of recovered viable cells.

Topics: Anti-Infective Agents, Local; Antineoplastic Agents; Bleomycin; Breast Neoplasms; Cell Line; Cell Survival; Cetrimonium Compounds; Chlorhexidine; Drug Combinations; Drug Screening Assays, Antitumor; Humans; Hydrogen Peroxide; Neoplasm Recurrence, Local; Noxythiolin; Povidone-Iodine; Therapeutic Irrigation; Tumor Cells, Cultured