povidone-iodine and Ischemia

The prevalence of ischaemic or infective delayed wound healing in amputations for peripheral vascular disease may vary from 18 to 40%. A prospective trial to test the efficacy of 12 h pre-operative preparation with 10% povidone-iodine was performed in a 1-year period, during which time 80 consecutive amputations were performed on 73 patients. Accrual to the treatment arm was incomplete and was principally due to extreme nursing shortages. Failure of randomization resulted in the study being analysed as if it were retrospective. Infection occurred in 14 (23%) of unprepared limbs but was not found in any of the 19 prepared limbs (P less than 0.05). Infection occurred in 11 of 34 unprepared limbs which had distal ulcers or moist gangrenous lesions; however, 15 prepared limbs which had similar distal lesions had no infection (P less than 0.025). The reduction of wound breakdown and infection resulted in a significant reduction in hospitalization prior to commencement of prosthetic fitting (P less than 0.001). Pre-operative antiseptic preparation played an important role in the reduction of infection following amputation for peripheral vascular disease, particularly for those patients whose amputation was required because of contaminated peripheral ischaemic lesions. However, these preliminary results should be confirmed by further study.

Topics: Aged; Amputation Stumps; Clinical Trials as Topic; Humans; Ischemia; Leg; Povidone; Povidone-Iodine; Premedication; Staphylococcal Infections; Staphylococcus aureus; Surgical Wound Infection

Topics: Administration, Topical; Adult; Anti-Infective Agents, Local; Cachexia; Chlorhexidine; Critical Care; Drug Substitution; Foot Ulcer; Humans; Hyperthyroidism; Ischemia; Male; Nephrectomy; Norepinephrine; Postoperative Complications; Povidone-Iodine

The efficacy of surface cooling and intraluminal antiseptic solutions for short term preservation of intestinal segments in preparation for free tissue transfer were investigated. Five segments of the small intestine and five segments of the colon were allocated to each group as follows: group 1, ischemia at 37 degrees C.; group 2, ischemia at 6 to 12 degrees C., and group 3, ischemia at 6 to 12 degrees C. plus povidone-iodine intraluminally. Histologic grading of segments allowed assessment of the efficacy of short term protection against ischemic changes. Surface cooling effectively prevented histologic evidence of ischemia. No additional benefit was observed using povidone-iodine intraluminally. Significant changes in tissue water content and evidence of bacterial invasion were not observed.

Topics: Animals; Anti-Infective Agents, Local; Body Water; Cold Temperature; Dogs; Intestine, Small; Ischemia; Organ Preservation; Povidone-Iodine; Tissue Preservation

Topics: Animals; Colon; Dogs; Hypothermia, Induced; Intestine, Small; Ischemia; Organ Preservation; Povidone; Povidone-Iodine; Tissue Preservation