povidone-iodine and Colonic-Diseases

The purpose of this work was to compare the efficacy and safety of the collagen-gentamicin sponge with conventional treatment (wound open, maintaining a close observation, and cleaning it daily with antiseptics) for the prophylaxis of infection in "dirty" abdominal wounds. Seventy-three patients with dirty abdominal wounds caused by gastrointestinal tract surgery were studied. The patients were randomized in two groups: group A, open wounds, treated with local cleansing, metronidazole 20 to 40 mg/kg/day IV and gentamicin 5 mg/kg/day IV for 7 days. Group B, primary closure with collagen-gentamicin implant plus metronidazole 20 to 40 mg/kg/day IV for 7 days. Surgical wound infections were significantly reduced by the collagen-gentamicin implant. Polymicrobial infections were observed in group A, whereas the infections were caused only by a single organism in group B. In conclusion, the collagen-gentamicin implant is effective and well tolerated in the treatment of "dirty" surgical abdominal wounds because it significantly reduces the wound infection rate (p < 0.01) and shortens healing time (p < 0.001) and the period of disability.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Appendicitis; Bacterial Infections; Collagen; Colonic Diseases; Drug Implants; Female; Gallbladder Diseases; Gelatin Sponge, Absorbable; Gentamicins; Humans; Intestinal Perforation; Male; Metronidazole; Middle Aged; Povidone-Iodine; Rupture, Spontaneous; Surgical Wound Infection; Wound Healing

Anaphylaxis during anaesthesia is a rare event which is mainly related to neuromuscular blocking agents. Latex and antibiotics are less frequently incriminated. However, allergy may be triggered by other less frequent and hidden allergen. Among these, povidone is largely used in numerous therapeutics and cosmetics. We report here an exceptional case of grade 3 anaphylactic shock with iodinated povidone administered via a rectal route.

Topics: Administration, Rectal; Anaphylaxis; Anti-Infective Agents, Local; Colectomy; Colonic Diseases; Combined Modality Therapy; Crystalloid Solutions; Diagnostic Errors; Drug Hypersensitivity; Epinephrine; Food Hypersensitivity; Humans; Intestinal Perforation; Isotonic Solutions; Male; Methylprednisolone; Middle Aged; Povidone-Iodine; Preanesthetic Medication; Shock, Septic; Wernicke Encephalopathy

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; Colonic Diseases; Female; Humans; Parenteral Nutrition, Total; Plasma Exchange; Polymyxin B; Povidone-Iodine; Stevens-Johnson Syndrome; Ulcer

Four patients with partial obstruction of the colon, in whom adequate standard preparation for colonic resection was not possible, are presented. Clinically, these patients did not show sufficient signs of obstruction to require a preliminary colostomy. A technique of quarantining the area of tumor resection from the abdominal cavity is described, allowing for adequate preparation of the colon lumen at the site of anastomosis. After completion of the anastomosis, a large caliber (36 French) colonic tube is inserted, per rectum, through the anastomosis and the proximal colon irrigated with Betadine solution adequately emptying and sterilizing the lumen of the bowel to allow for primary anastomosis without a protective colostomy. The criteria for selection of patients for this technique are discussed. No complications, of significance, ensued. This method of intraoperative rectal tube irrigation, for prevention of colostomy in partial colonic obstruction, is safe when properly performed in the appropriate patient.

Topics: Adult; Aged; Colonic Diseases; Colostomy; Female; Humans; Intestinal Obstruction; Intraoperative Care; Methods; Middle Aged; Postoperative Care; Povidone; Povidone-Iodine; Rectum; Therapeutic Irrigation

A technique for intraoperative segmental preparation of the large bowel, using 10% povidone iodine, was evaluated in 25 patients undergoing elective colon resection. Qualitative and quantitative bacteriology was obtained from the normal bowel content and from segments of colon treated with povidone iodine or normal saline. Forty-five of 50 segments treated with povidone iodine demonstrated no growth, whereas the segments injected with normal saline maintained bacterial counts of 3.5 x 10(8) colony forming units per milliliter. There were no septic complications in this group of patients and the levels of triiodothyroninc and thyroxin remained unchanged despite a substantial absorption of iodine, as demonstrated by protein-bound iodine determinations. Intraoperative segmental preparation of the colon with 10% povidone iodine is a simple technique that may be useful in the enhancement of other methods of bowel preparation by further reducing the endogenous bacterial inoculum at the time of transection of the colon.

Topics: Adult; Aged; Bacteria; Carcinoma; Colon; Colonic Diseases; Colonic Neoplasms; Humans; Iodine; Middle Aged; Povidone; Povidone-Iodine; Thyroxine; Triiodothyronine

In controlled experiments intraperitoneal povidone-iodine significantly reduced the mortality of mice (p less than 0.01) and rats (p less than 0.01) with induced peritonitis. Povidone-iodine irrigation of the rat colon before and after anastomosis did not interfere with healing or inhibit peritoneal adhesion formation. However, a newly formulated povidone-iodine solution containing increased PVP significantly reduced adhesion formation in a controlled study in rats.

Topics: Animals; Colonic Diseases; Female; Gastrointestinal Diseases; Injections, Intraperitoneal; Mice; Peritoneal Cavity; Peritoneal Diseases; Peritonitis; Postoperative Complications; Povidone; Povidone-Iodine; Rats; Tissue Adhesions; Wound Healing