povidone-iodine and Hypersensitivity

Surgical site infections (SSIs) are among the most common nosocomial infections in surgery patients. Two types of preparations, povidone-iodine and chlorhexidine-alcohol, are commonly used in preoperative antiseptic procedures worldwide. However, there are inconsistencies among international guideline recommendations concerning skin antiseptics. This trial aimed to evaluate the superiority of olanexidine, which reduced SSI rates more than povidone-iodine in our previous randomised trial, over chlorhexidine-alcohol in clean-contaminated surgery.. This multicentre randomised controlled clinical trial will compare two antiseptics (1.5% olanexidine and 1.0% chlorhexidine-alcohol) to prevent SSI in clean-contaminated gastrointestinal surgeries with surgical wounds. On providing consent, patients aged <18 years will be included. The primary outcome will be the postoperative 30-day overall SSI rate, while the secondary outcomes will be the postoperative 30-day superficial incisional SSI rate, deep incisional SSI rate, organ/space SSI rate, positive bacterial wound culture rate, cultured bacterial strains, rates of intervention-related toxicity and allergic events (eg, erythema, pruritus, dermatitis and other symptoms of allergy around the region disinfected by the antiseptic during surgery), rate of reoperations due to SSI, medical economic effect indicators (based on health insurance claims) and hospital duration. The Mantel-Haenszel method will be used to estimate the adjusted risk ratio and its 95% CI for the primary analysis, which will compare the treatment effects.. The protocol was approved by the Institutional Review Board of Keio University School of Medicine and subsequently by the board of each participating site. Participant recruitment began in January 2023. The final results will be published in medical journals after international peer review.. UMIN000049712.

Topics: Anti-Infective Agents, Local; Antisepsis; Chlorhexidine; Digestive System Surgical Procedures; Ethanol; Humans; Hypersensitivity; Incidence; Multicenter Studies as Topic; Povidone-Iodine; Randomized Controlled Trials as Topic; Surgical Wound Infection

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Cataract Extraction; Endophthalmitis; Eye Infections, Bacterial; Humans; Hypersensitivity; Iodine; Postoperative Complications; Povidone-Iodine; Self Report

A 14-year-old girl developed an eruption on her upper arm of pruritic, follicular papules each time she received a vaccination. This was initially thought to be a local reaction to the vaccines. After a similar rash appeared at a venepuncture site, a contact allergy to the alcohol swabs used before the procedures was postulated. A repeated open application test clarified this observation.

Topics: 2-Propanol; Adolescent; Anti-Infective Agents, Local; Dermatitis, Allergic Contact; Diagnosis, Differential; Female; Humans; Hypersensitivity; Phlebotomy; Povidone-Iodine; Viral Vaccines

Topics: Cesarean Section; Dose-Response Relationship, Drug; Female; Humans; Hypersensitivity; Infant; Iodine; Povidone-Iodine; Pregnancy; Thyroid Gland

To assess the effect of surgical cleaning of the skin on the pathergy phenomenon in Behçet's syndrome.. The pathergy phenomenon was assessed in 183 patients with Behçet's syndrome in a single blind study at 48 hours after a needle prick of the forearm skin, cleaned in the conventional way with alcohol, with 10% povidine iodine, with 100% chlorhexidine, and with a 4% aqueous solution of chlorhexidine.. The surgical cleaning of the forearm with povidone iodine before the application of the needle prick reduced the prevalence of the pathergy reaction to 27% from 48% in the conventionally (by alcohol swab) cleaned forearm. Cleaning the forearm with 100% chlorhexidine reduced the prevalence of the pathergy to 36% from 59% in the conventionally cleaned forearm. No significant changes were observed with a 4% aqueous solution of chlorhexidine.. Surgical cleaning of the skin with disinfectants of various concentrations reduces the prevalence of a positive pathergy test in Behçet's syndrome. This implies that more than the disruption of the structural integrity of the dermis and epidermis is involved in the production of the pathergy phenomenon in Behçet's syndrome.

Topics: Behcet Syndrome; Chlorhexidine; Disinfectants; Ethanol; Humans; Hypersensitivity; Povidone-Iodine; Single-Blind Method; Skin Tests