povidone-iodine and Hernia--Umbilical

Well established and common practice in conservative management of omphalocele major is escharotics therapy with different topical agents. Among them mercurochrome, alcohol, silver salts, povidone iodine, acacia nilotca paste are commonly used. It is a comparative study between application of acacia nilotica paste and povidone iodine solution as a primary non surgical treatment of omphalocele major regarding efficacy and safety of these two topical agents. A double blind randomized controlled study was conducted at the department of Paediatric Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2016 to June 2019. In this study 20 cases of omphalocele major and randomly divided into two equal groups. Group A and Group B treated with acacia nilotica paste and povidone iodine solution respectively. Gastroschisis, ruptured-omphalocele major or omphalocele minor excluded in this study. The size of the fascial defect in cm, time required for full oral feeding tolerance and duration of hospital stay were evaluating parameters. Patients with Group A tolerated full oral feeding earlier, shorter total hospital stay duration and low mortality rate than those from Group B. Application of acacia nilotica is a safe and effective treatment of omphalocele major regarding rapid full oral feeding tolerance, shorter hospital stay and low mortality rate.

Topics: Acacia; Anti-Infective Agents, Local; Child; Hernia, Umbilical; Humans; Merbromin; Povidone-Iodine; Salts; Silver

The aim of the study was to evaluate topical povidone-iodine and topical powdered antibiotic combination (Polymyxin, Bacitracin and Neomycin) in initial non-operative management with delayed closure of the defect of giant omphaloceles.. A prospective study was conducted between July 2010 and June 2013 including all neonates with giant omphalocele without signs of intestinal obstruction. All cases were managed by daily application of povidone-iodine (5% solution) followed by spraying topical powdered antibiotic combination to promote eschar formation and eventual epithelialisation. Record was made of sex, associated anomalies, length of stay, and thyroid function tests.. Twenty-four neonates with giant omphaloceles were treated with topical povidone-iodine and topical powdered antibiotic combination. No sac ruptures were observed in our series. All patients had a normal thyroid function test at presentation and after 10 days of initiation of treatment. Six patients have undergone delayed repair.. Topical povidone-iodine and powdered antibiotic combination promotes more rapid escharification and epithelialisation of the omphalocele than povidone-iodine alone. We also hypothesise that combination minimises the chances of hypothyroidism associated with use of povidone-iodine alone.

Topics: Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents, Local; Drug Therapy, Combination; Female; Hernia, Umbilical; Humans; Infant, Newborn; Male; Povidone-Iodine; Powders; Prospective Studies; Tertiary Care Centers

The aim of the study was to evaluate topical povidone-iodine as a bridge to delayed fascial closure of giant omphaloceles with emphasis on its effect on thyroid function.. Newborns from a single institution with giant omphaloceles treated with topical povidone-iodine for a 10-year period were reviewed. Recorded data included sex, associated anomalies, length of stay, frequency of povidone-iodine application, thyroid function tests, frequency of laboratory draws, and thyroid supplementation administration.. Six neonates with giant omphaloceles were treated with povidone-iodine. Thyroid function testing occurred weekly as inpatients and monthly as outpatients, with abnormal values normalized by the subsequent laboratory draw. One patient demonstrated persistent hypothyroidism and subsequently died secondary to cardiac complications, but this infant's newborn thyroid screening suggested congenital hypothyroidism. Five patients remained euthyroid and ultimately achieved fascial closure without the need for a prosthetic implant. None of these patients had abnormal outpatient thyroid tests nor did they require thyroid hormone supplementation.. Topical povidone-iodine promotes escharification and epithelialization of the omphalocele sac. Because transient hypothyroidism may occur, thyroid function studies may guide inpatient therapy. After sac desiccation, systemic effects of iodine are minimal and thyroid supplementation is not necessary. Topical povidone-iodine is an effective initial strategy for giant omphaloceles and does not produce clinically significant hypothyroidism.

Topics: Administration, Topical; Anti-Infective Agents, Local; Female; Follow-Up Studies; Gestational Age; Hernia, Umbilical; Humans; Infant, Newborn; Male; Povidone-Iodine; Retrospective Studies; Severity of Illness Index; Thyroid Gland; Thyroid Hormones; Treatment Outcome

Giant omphaloceles, especially if they contain liver tissue, remain the greatest challenge to pediatric surgeons for the coverage of the huge defect. Various reconstructive techniques have been described in the literature, each with advantages and disadvantages. Standard treatment has been placement of a Silastic silo to allow gradual return of abdominal organs to the abdomen with its limited space. The worst complication of silo placement is infection of the fascia with disruption of the suture line. When fascial infection occurs, closure of the abdominal wall is very difficult or impossible. In this report, the authors describe their experience in treating 5 patients with giant omphaloceles, between 1999 and 2003, utilizing an abs orbable synthetic mesh (polyglactin 910-Vicryl) for abdominal closure and topical application of povidone-iodine 10/100 solution (Betadine) to prevent infection. All patients had perfect results with the simple postoperative care, early oral feeding and were discharged after 2 months of hospitalization with complete skin coverage.

Topics: Administration, Topical; Anti-Infective Agents; Biocompatible Materials; Female; Hernia, Umbilical; Humans; Male; Plastic Surgery Procedures; Polyglactin 910; Povidone-Iodine; Surgical Mesh; Wound Healing; Wound Infection

A case of physiologic hypothyroidism caused by the topical application of povidone-iodine (PVPI) in a newborn with an omphalocele is presented. The literature on systemic absorption and effects of PVPI is reviewed. A management strategy is offered.

Topics: Administration, Cutaneous; Hernia, Umbilical; Humans; Hypothyroidism; Infant, Newborn; Male; Povidone; Povidone-Iodine

Topics: Alcohols; Female; Hernia, Umbilical; Humans; Hypothyroidism; Infant, Newborn; Povidone; Povidone-Iodine; Thyroid Function Tests

Topics: Female; Hernia, Umbilical; Humans; Hypothyroidism; Infant, Newborn; Infant, Newborn, Diseases; Povidone; Povidone-Iodine; Thyroid Gland