povidone-iodine and Edema

To compare the clinical efficacy of different povidone iodine concentrations for the management of postoperative pain and swelling following mandibular third molar surgery.. The randomised, prospective, double-blind and controlled study was conducted from October 2016 to January 2018 at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul, Turkey, and comprised individuals aged 18-30 years who underwent surgical removal of pathology-free completely unerrupted mandibular lower third molars. The participants were randomly assigned to four groups: Group I had saline-only controls, Group II was given 0.5% concentration of povidone iodine, Group III had 1% concentration of povidone iodine, and Group IV had 3% concentration of povidone iodine. Facial swelling and trismus were assessed on the 2nd and 7th postoperative days. Data was analysed using SPSS 22.. Of the 80 patients, 34(42.5%) were males and 46 (57.5%) were females with an overall mean age of 24.6±3.68 years. Each group had 20 (25%) subjects. All three concentrations of povidone iodine provided significant reduction in postoperative trismus compared to the controls. Trismus was less in Group III and Group IV compared to Group II up to 7 days after surgery.. Irrigation with 3% povidone iodine concentration was found to be more effective in reducing the level of facial swelling after impacted third molar surgery. (Clinical Trials.gov Identifier: NCT03894722).

Topics: Adolescent; Adult; Edema; Female; Humans; Male; Mandible; Molar, Third; Pain, Postoperative; Povidone-Iodine; Prospective Studies; Tooth Extraction; Tooth, Impacted; Trismus; Turkey; Young Adult

The present study was conducted to assess the effect of irrigation with three different irrigants, namely normal saline, chlorhexidine, and povidone iodine on pain, alveolar osteitis, swelling, trismus, infection, and food impaction during surgical removal of impacted mandibular third molar.. Forty-eight patients, including 26 males and 22 females, fulfilling criteria for inclusion in this study were divided into three groups: group I where irrigant used was normal saline, group II as chlorhexidine, and group III as povidone iodine group.. The pain was significantly more in groups I and III in 24 hours and 7th day as well. Alveolar osteitis was noted in groups III and I, nil in group II. The facial swelling measured in millimeters on 24 hours and on 7th day was significantly higher in 24 hours in groups I and III than in group II. Trismus was significantly more in group I and group III than in group II (with p < 0.01) on 7th day.. It is concluded that chlorhexidine is effective in reducing pain, alveolar osteitis, swelling, and trismus when used as an irrigant following surgical removal of impacted third molar.. Chlorhexidine as irrigating solution helps in reducing the postoperative consequences after third molar surgery. Further studies are required using large sample size.

Topics: Adult; Chlorhexidine; Cross-Sectional Studies; Dry Socket; Edema; Female; Humans; Intraoperative Care; Male; Molar, Third; Pain, Postoperative; Postoperative Complications; Povidone-Iodine; Saline Solution; Solutions; Therapeutic Irrigation; Tooth Extraction; Tooth, Impacted; Treatment Outcome; Trismus; Young Adult

Povidone iodine is used primarily as an antiseptic to decrease surgical site infection. Its hemostatic and antiedematous properties in oral surgery also have been investigated recently.. A randomized controlled clinical trial was performed in 30 patients undergoing mandibular third molar removal in a split-mouth design. In the study group, a povidone iodine solution with a concentration of 0.5 mg/mL was used as the coolant and irrigant solution, whereas normal saline was used in the control group. Swelling (orotragus and mentotragus distances), trismus (maximum interincisal opening), and pain (visual analog scale score) were evaluated on postoperative days 2 and 7.. In the study group, a significant decrease in swelling and trismus was observed at the 2 postoperative visits (P = .00) compared with the control group. The decrease of pain in the study group was not statistically significant at either postoperative visit (P > .05). More patients (63%) were subjectively satisfied with the side treated with povidone iodine.. Povidone iodine irrigation is an inexpensive and safe method to lessen the postoperative sequelae of third molar surgery.

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Edema; Female; Follow-Up Studies; Humans; Male; Mandible; Molar, Third; Pain, Postoperative; Patient Satisfaction; Pilot Projects; Postoperative Complications; Povidone-Iodine; Prospective Studies; Sodium Chloride; Therapeutic Irrigation; Tooth Extraction; Tooth, Impacted; Trismus; Visual Analog Scale; Young Adult

Polyvinylpyrrolidone-iodine (PVP-I) is a well-known antiseptic, widely used in various preparations and concentrations in all surgical fields. It is also used as an irrigant for open wounds and in some centres for irrigating sockets after tooth extraction. One of the authors (GA) incidentally discovered an anti-oedematous effect of PVP-I after using it in low concentration as an irrigant/coolant during the surgical removal of lower third molars. A prospective randomized clinical trial was subsequently performed on 50 patients (25 control, 25 treatment group) undergoing removal of impacted lower third molars. In the treatment group a 0.5% PVP-I solution at a concentration of 0.5mg/ml (we call it as "Arakeri's iodine solution") resulted in a significant reduction in postoperative swelling compared with the control group (P<0.01). This effect of PVP-I was suspected due to its inhibitory effect on leukotriene B4 and leukocyte extravasation (chemotaxis). Further evaluation of the effects of PVP-I as an irrigant in oral and maxillofacial surgery is needed.

Topics: Adult; Anti-Infective Agents, Local; Chemotaxis, Leukocyte; Edema; Female; Humans; Leukotriene B4; Male; Mandible; Molar, Third; Povidone-Iodine; Prospective Studies; Single-Blind Method; Tooth Extraction; Tooth, Impacted; Young Adult

To investigate if a second drop of 2.5% povidone-iodine ophthalmic solution placed within the first postnatal day would achieve better prophylaxis against ophthalmia neonatorum than a single drop applied at birth.. A masked, prospective, controlled trial was conducted over a 2 year period in a Kenyan hospital. Randomisation was achieved by alternating weeks of one or two eye drop application to both eyes. All 719 neonates received one drop of the povidone-iodine solution to both eyes at birth, while 317 received a second drop at hospital discharge or 24 (SD 4) hours after delivery, whichever was first. All infants developing conjunctivitis within a month after birth underwent microbiological analysis using Gram and Giemsa stains, direct fluorescent antibody assay for Chlamydia trachomatis, and culture.. Of the neonates receiving the one eye drop application, 18.4% returned with a red eye with discharge, 4.0% had organisms found on the initial smear, and 8.2% had a positive culture. The corresponding proportions for the multidrop group were 24.3%, 4.7%, and 10.4%. Of those returning with an inflamed eye, there were no cases of Neisseria gonorrhoeae, 4.2% in the single dose group and 3.9% in the double dose group were positive for C trachomatis, and 5.4% and 6.5% respectively for Staphylococcus aureus. At discharge, the eyelid oedema score of the double dose group was mildly greater than the single dose group (1.4 (0.67) v 1.2 (0.73), p=0.0002). There was no statistically significant difference between the groups in any other category.. There is no advantage to administering povidone-iodine prophylaxis against ophthalmia neonatorum twice in the first postnatal day over a single application at birth.

Topics: Anti-Infective Agents, Local; Chlamydia Infections; Developing Countries; Drug Administration Schedule; Edema; Eyelid Diseases; Female; Fluorescent Antibody Technique, Direct; Humans; Infant, Newborn; Kenya; Male; Ophthalmia Neonatorum; Ophthalmic Solutions; Povidone-Iodine; Prospective Studies

Recent reports in the literature have indicated that dextranomer (Debrisan; Adcock-Ingram) is an effective cleansing agent for the secreting wound. To evaluate its possible use in the initial cleansing of the infected secreting stasis ulcer, 100 patients were incorporated in a single-blind randomized trial. The mean cleansing time for the Debrisan-treated ulcers was 5,9 days, compared with 15,4 days for the control group receiving standard treatment. The average healing time for ulcers treated with Debrisan and left to heal spontaneously was 4,4 weeks compared with 5,32 weeks for the controls. Debrisan, furthermore, decreased the amount of local tissue oedema and alleviated local pain in the majority of patients. It is feasible to use Debrisan for outpatient treatment and without additional staff in a busy clinic. The cost of Debrisan therapy appeared to be reasonable. A hydrophilic cleansing agent such as Debrisan has a definite place in the early treatment of the secreting infected post-phlebitic stasis ulcer.

Topics: Chlorohydrins; Clinical Trials as Topic; Debridement; Dextrans; Edema; Epichlorohydrin; Female; Granulation Tissue; Humans; Male; Pain; Phlebitis; Povidone-Iodine; Random Allocation; Time Factors; Varicose Ulcer; Wound Healing

The purpose of this study was to assess the effect of a second povidone-iodine (PVP-I) application at the time of donor tissue recovery on overall tissue quality and to analyze the rate of positive fungal and bacterial rim cultures before and after implementing increased PVP-I exposure.. The left cornea was recovered after a single application of PVP-I, while the right cornea was recovered after double PVP-I application in research-consented donors. The epithelial cell death rate was estimated using viability assay in corneal whole mounts under 10× objective (n = 5). Clinical characteristics of epithelium, stroma, and endothelium; positive rim culture rate; and incidences of infectious postoperative adverse reactions were compared for a period of 14 months before and after implementation of increased PVP-I protocol.. The average epithelial cell death rate was unaltered between single and double PVP-I exposure groups. We observed a modest 10% increase in the number of tissues with mild edema after implementation of increased PVP-I exposure. Nonetheless, the percentage of tissues with moderate or severe edema was unaltered. The average positive rim culture rate decreased from 1.17% to 0.88% (P = 0.075) after implementation of the double PVP-I soak procedure. There has been only one report of infectious postoperative adverse reactions since this procedure change. By contrast, there were 5 reports for a period of 14 months before implementation of this protocol.. These results indicate that new donor preparation methods with an additional 5 minutes of PVP-I exposure do not affect tissue quality, reduce positive rim cultures, and lead to lower incidence of postoperative infection.

Topics: Cornea; Edema; Epithelium, Corneal; Humans; Povidone; Povidone-Iodine

This study was conducted to compare the efficacy of using 0.5 mg/mL povidone-iodine solution as an irrigant and coolant in reducing postoperative sequelae like swelling, trismus, and pain with the conventional normal saline irrigation during the surgical removal of the impacted lower third molar.. The research was conducted out toward the MES Dental College in Perinthalmanna, Kerala, in the Department of Oral and Maxillofacial Surgery. After mandibular third-molar surgical removal, researchers studied 60 individuals, 30 of whom had normal saline irrigation (group I), and 30 of whom received 0.05% povidone-iodine irrigation (group II). The postoperative discomforts were measured on the second and seventh days after surgery, respectively. After that, the data were analyzed using SPSS. The data analysis considered. At the second postoperative visit, patients in the povidone-iodine group reported much less pain, swelling, and reduced mouth opening than those in the normal saline group. But on the seventh postoperative day, there was not much difference between either group.. Following the surgical removal of teeth, it was revealed that povidone-iodine solution (0.5 mg/mL) was more effective as irrigation and cooling aid than regular saline solution.. Low-concentrated povidone-iodine is a better option in dentistry as irrigant.

Topics: Edema; Humans; Molar, Third; Pain; Postoperative Complications; Povidone-Iodine; Saline Solution; Tooth Extraction; Tooth, Impacted

Povidone-iodine, a surgical antiseptic, is associated with adverse side effects ranging from minor skin irritation to anaphylaxis, with symptoms occurring within minutes and up to 8 hours after contact.. We report a case of a patient, with no history of allergy to povidone-iodine, who developed an allergic reaction 24 hours after intraoperative exposure to povidone-iodine, presenting with acute urinary retention secondary to extensive vulvar edema, which resolved after administration of antihistamines.. Allergic reactions to povidone-iodine can be late in onset and, in vaginal surgeries, may present with atypical symptoms such as acute urinary retention secondary to vulvar edema. Prompt diagnosis and effective treatment requires strong clinical suspicion in patients presenting postoperatively with a known history of exposure.

Topics: Anti-Infective Agents, Local; Drug Hypersensitivity; Edema; Female; Histamine Antagonists; Humans; Middle Aged; Povidone-Iodine; Time Factors; Urinary Retention; Vulvar Diseases

Gossypiboma is derived from the Latin word gossypium, meaning cotton, and it means a postoperatively retained foreign body used in operations. Several cases of gossypiboma have been reported especially after abdominal surgery, but there has not been any reported case in plastic surgery. Mandibular contouring surgery cannot ensure a view wide enough to avoid injury to surrounding structures such as a facial artery and a retromandibular vein. In addition, many surgeons pack the sponge into the operative field to prevent bleeding, and surgeons may neglect remnant surgical materials. Recognition of gossypiboma is essential but is often considerably delayed and cause medicolegal problems. Therefore, it is important to ensure that every effort is made to prevent such occurrences. We had a chance to evaluate and treat gossypiboma, and in this paper, we want to share our experiences.. In circa 1999 to 2007, there were 3 cases diagnosed as gossypiboma after a mandible angle surgery. All patients were female, and some had signs of fever, swelling, tenderness, and purulent discharge of an oral wound. We performed a computed tomographic scan and blood test, and foreign body removal was done under general anesthesia. Intraoperatively, the diagnosis of gossypiboma was confirmed.. All symptoms were reduced or subsided after surgery. It was noted that no postoperative infection remained.. Gossypiboma must be considered when fever, unilateral swelling, tenderness, or unhealed oral wound is sustained despite an antibiotics therapy and a drainage procedure after a mandible angle surgery. In that case, a computed tomographic scan can be recommended as an effective method for detection of gossypiboma.

Topics: Adult; Anti-Infective Agents, Local; Curettage; Edema; Female; Fever; Foreign Bodies; Humans; Mandible; Middle Aged; Plastic Surgery Procedures; Povidone-Iodine; Suppuration; Surgical Sponges; Surgical Wound Dehiscence; Surgical Wound Infection; Therapeutic Irrigation; Tomography, X-Ray Computed

Previous studies have shown the antidotal efficacy of topical iodine at 15 and 30 min post-exposure to sulfur mustard (SM). Here we demonstrate efficacy at longer intervals (20, 30, 45, and 60 min, respectively, for data) using an improved topical povidone-iodine preparation termed N66, which contains steroidal and non-steroidal anti-inflammatory agents. In the mouse, N66 reduced severity of ear edema by 43, 47, 44, and 36%; ear epidermal ulceration by 74, 58, 45, and 58%; and epidermal necrosis by 54, 34, 26, and 31% at the respective time points. A similar effect was observed with encrustation. The healing marker, grade of acanthotic area, showed dramatic increases of 39.6-, 25.3-, 20.9-, and 22-fold. Severity of the dermal parameters, acute inflammation and dermal necrosis, was reduced by 63, 34, 34, and 38% and 80, 54, 54, and 59%, respectively. In guinea pig skin, topical treatment with N66 45 min post-exposure reduced the SM-induced ulceration area by 75%. The histological parameters subepidermal microblister formation, epidermal ulceration, epidermal necrosis, and encrustation were reduced by 63, 61, 41, and 41%, respectively. The healing marker, grade of acanthotic area, was elevated by 73%. N66 induced a statistically significant reduction in two dermal markers for tissue damage: acute inflammation (33%) and dermal necrosis (48%). Reduced skin damage was also observed in areas adjacent the treated sites. The pharmacologically active components of N66 showed additive effect. These findings suggest that the povidone-iodine preparation combined with anti-inflammatory agents functions as a potent antidote against skin lesions induced by SM at relatively long intervals between exposure and treatment.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Chemical Warfare Agents; Clobetasol; Disease Models, Animal; Drug Combinations; Ear Diseases; Edema; Guinea Pigs; Male; Mice; Mice, Inbred ICR; Mustard Gas; Piroxicam; Povidone-Iodine; Protective Agents; Skin; Skin Diseases; Skin Irritancy Tests; Time Factors

The authors report a series of thirty-six perforating ulcers of the foot in diabetic patients, evaluated using M.R.I. M.R.I. showed osteomyelitis in 16 cases, cellulitis in 15 cases, osteoarthropathies in 21 cases, tenosynovitis of flexor tendons in 2 cases, oedema in 2 cases and abscess in one case. In 19 cases, M.R.I. was used to improve diagnostic accuracy. The medical treatment made use of thermo-moulded soles allowing for the recovery of walking, with a hole facing the perforating ulcer of the foot. The application of insulin-soaked sponges in the event of clean perforating ulcer of the foot and iodized solution in the event of infected perforating ulcer of the foot promoted healing. The treatment was only conservative, when the lesions were limited to the soft tissues. Surgical treatment was performed in 19 cases due to a global involvement of soft and osteoarticular tissues. In fourteen cases the surgical treatment was limited and was performed through the perforating ulcer. Resection of metatarsal heads or metatarso-phalangeal joints was performed in 10 cases, with resection of surrounding pathologic tissue. The surgical treatment was limited to the soft tissues in 6 cases. In 4 cases, M.R.I. findings resulted into a transmetatarsal amputation because the vascular plexus was of poor quality and infection spread from the perforating ulcer to the dorsal aspect of the foot. In our opinion, dorsal infectious involvement in a perforating ulcer of the foot, is a factor of poor prognosis. A below-knee amputation has been performed in one patient.

Topics: Abscess; Administration, Cutaneous; Adult; Aged; Amputation, Surgical; Anti-Infective Agents, Local; Bacterial Infections; Cellulitis; Diabetic Foot; Edema; Equipment Design; Follow-Up Studies; Foot Diseases; Humans; Hypoglycemic Agents; Insulin; Magnetic Resonance Imaging; Metatarsal Bones; Metatarsophalangeal Joint; Middle Aged; Osteoarthritis; Osteomyelitis; Povidone-Iodine; Prognosis; Shoes; Tenosynovitis; Walking; Wound Healing

Topics: Edema; Humans; Leg; Lower Extremity; Povidone-Iodine; Pressure