povidone-iodine and Pressure-Ulcer

We describe an elderly man who was admitted with congestive cardiac failure and found to have thyrotoxicosis. He did not have goiter, and he had normal radioiodine uptake in his neck. Serum iodine levels were elevated, explaining the lack of increase in radioiodine uptake in the thyroid gland. He had multiple pressure sores, which were treated with povidone-iodine (Betadine) soaks. Biochemical data were consistent with Graves' disease unmasked by topical iodine application. Povidone-iodine soaks are commonly used in decubitus ulcer care and warrant special attention in patients with preexisting thyroid disorders. We have reviewed the literature on this unusual complication.

Topics: Administration, Topical; Aged; Graves Disease; Heart Failure; Humans; Male; Povidone-Iodine; Pressure Ulcer; Thyrotoxicosis

To compare a hydrogel dressing with a conservative topical wound-care regimen (gauze with povidone-iodine) for the treatment of pressure ulcers.. A prospective study comprising 27 (24 male and three female) spinal-cord injury patients with a total of 49 pressure ulcers. Wounds were randomised into a treatment group (n=25) or control group (n=24). The primary outcome measure was the rate of wound healing (cm2/days).. Healing rates in the treatment group were higher than in the control group, although this was not statistically significant. Some 84% of the wounds in the treatment group and 54% in the control group epithelialised, which was statistically significant (p=0.04). The mean healing time in the treatment group was 48 days compared with 45 days for the controls.. Our results suggest that hydrogel occlusive wound dressings facilitate healing by promoting more rapid epithelialisation of pressure ulcers, when compared with conservative wound care.

Topics: Administration, Cutaneous; Adolescent; Adult; Bandages; Bandages, Hydrocolloid; Female; Hemoglobins; Humans; Lymphocyte Count; Male; Middle Aged; Povidone-Iodine; Pressure Ulcer; Serum Albumin; Severity of Illness Index; Skin Care; Spinal Cord Injuries; Time Factors; Treatment Outcome; Wound Healing

A randomized prospective study was done to evaluate the two treatments for pressure sores infected with methicillin-resistant Staphylococcus aureus in elderly patients: Gentian violet plus dibutyryl cAMP (GVcAMP, n = 8) and povidone-iodine plus sugar (IS, n = 11). Age, underlying diseases, and nutritional status did not differ between the two groups. Specimens were obtained biweekly from the pressure sores and were cultured. The percentage of culture dishes with no methicillin-resistant S. aureus was 93% for the patients given GVcAMP, but only 74% for those given IS (p < 0.01). By the 14th week after the start of treatment, the mean area of the pressure sores in the GVcAMP group had decreased to 45% of the area at the start of treatment. In the IS group, the decrease was smaller to 56% of the area before treatment. No local or systemic adverse effects occurred in either group. GVcAMP is useful to treat pressure sores infected with methicillin-resistant S. aureus.

Topics: Aged; Aged, 80 and over; Bucladesine; Drug Combinations; Female; Gentian Violet; Humans; Methicillin Resistance; Ointments; Povidone-Iodine; Pressure Ulcer; Prospective Studies; Staphylococcal Infections; Staphylococcus aureus

The presence of bacteria and local infection is an important factor in the local management of chronic pressure ulcers. For successful closure of the ulcer, the bacterial count should be 10(5) or less per gram of tissue in the granulating wound. In a prospective randomized study of 45 (eventually 40) hospitalized patients, silver sulfadiazine (Silvadene) cream and povidone-iodine (Betadine) solution were compared to physiologic saline for effectiveness in preparing pressure ulcers for closure. Quantitative bacteriologic techniques on tissue biopsy specimens were used for objective evaluation. In 100 percent of the ulcers treated with silver sulfadiazine cream (15 patients) the bacterial counts were reduced to 10(5) or less per gram of tissue within the three-week test period, compared to 78.6 percent in those treated with saline (14 patients) and 63.6 percent in those treated with povidone-iodine solution (11 patients). Moreover, the ulcers treated with silver sulfadiazine cream responded more rapidly, with one-third showing bacterial levels of less than 10(5) within three days, and half within a week.

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Povidone; Povidone-Iodine; Pressure Ulcer; Silver Sulfadiazine; Sodium Chloride; Sulfadiazine

To determine the clinical efficacy of recombinant human epidermal growth factor (rh-EGF) combined with povidone-iodine (PVI) on patients with pressure ulcers (PUs).. One hundred and five PU patients treated between January 2018 and January 2021 were enrolled and retrospectively analyzed. Of them, 50 patients who received conventional treatment were assigned to the control group (Con group), while 55 patients treated with rh-EGF combined with PVI were assigned to the observation group (Obs group). The two groups were compared in clinical efficacy, PU alleviation (total area reduction rate, total depth reduction rate, and total volume reduction rate), healing time, pain degree (Visual Analog Scale [VAS] score), inflammatory indexes (interleukin-8 [IL-8], tumor necrosis factor-. The Obs group yielded a higher total effective rate than the Con group (. All in all, rh-EGF combined with PVI has a definite curative effect on patients with PUs. It can promote PU alleviation and hydroxyproline secretion in the wound and inhibit pain and inflammatory reactions, which is worthy of clinical promotion.

Topics: Cytokines; Epidermal Growth Factor; Humans; Hydroxyproline; Immunologic Factors; Inflammation; Pain; Povidone-Iodine; Pressure Ulcer; Retrospective Studies; Suppuration

The treatment of bedsores is a particular problem in geriatric medicine. We selected standard drugs that may be effective for the decubitus ulcer, and investigated combination therapy to develop efficient treatment The subjects were 16 patients in whom the grade of the bedsore was evaluated as II to IV according to the Shea's depth classification. Treatment was performed while all patients were on air mats. We selected drugs and treatment methods based on the previously established experimental design of Taguchi. Based on this, we created and adapted 16 different component combination treatment programs in accordance with the L16 rectangular cross table. The following component factors were adopted: A: types of covering substances on the wound surface (Elase ointment, isodine sugar, isodine gel solcoseryl ointment); B: Isalopan powder; C: Spray of 10 ml physiological saline containing 500 microg of prostaglandin (concentration 0.005%); D: daily number of treatments; and F: presence or absence of tapping. We serially measured the wound surface area as an index of the speed of wound healing, and measured the interval (day) until the area decreased to one half of the original size (T1/2, half life). We analyzed data on one combination treatment each in 16 patients. Analysis of variance of the above factors showed significant F values for factors A, B, D and F. The contribution rates for factors A, B, D and F were 37.84%, 8.47%, 14.98% and 13.81%, respectively. The error term (e) was 16.37%. Optimal results were seen in the groups in which solcoseryl ointment had been applied twice a day. In this study, prostaglandin, which had been anticipated to be effective, did not show any effects. The error term (e) suggests the presence of other healing factors including individual differences. Concerning this point, it well be necessary to examine a larger number of patients in the future. With ointment treatment alone, without using an air mat, it was confirmed that bedsore area reduction was extremely unstable. Decompression of the affected part may be a basic prevention factor and essential treatment of bedsores.

Topics: Actihaemyl; Aged; Beds; Deoxyribonucleases; Drug Combinations; Fibrinolysin; Gels; Humans; Ointment Bases; Ointments; Povidone-Iodine; Powders; Pressure Ulcer; Prostaglandins; Research Design; Wound Healing

Topics: Aged; Anti-Infective Agents, Local; Bandages; Humans; Male; Nursing Assessment; Nutritional Support; Povidone-Iodine; Precipitating Factors; Pressure Ulcer; Severity of Illness Index; Skin Care; Therapeutic Irrigation; Wound Healing

We investigated the efficacy of infection control measures against nosocomial pneumonia in geriatric wards. Cases with nosocomial pneumonia were retrospectively analyzed between January 1991 and March 1995. The study period was divided into four annual periods (periods 1, 2, 3 and 4). Period 1, January to December 1991, was applied as the cotrol. We investigated patients with nosocomial pneumonias in geriatric wards (190 beds) of AINO Memorial Hospital, affiliated with Nagasaki University. During the study period, nosocomial pneumonia significantly diminished. (period 1 vs periods 2, 3 and 4, p < 0.05, p < 0.05, p < 0.05, respectively). Major causative organisms of nosocomial pneumonia were MRSA and Pseudomonas aeruginosa. During the four periods, a significant reduction in cases with MRSA- and P. aeruginosa-induced nosocomial pneumonia was observed (MRSA: period 1 vs periods 2, 3 and 4, p < 0.05, p < 0.05, p < 0.01, respectively; P. aeruginosa: period 1 vs period 3, p < 0.01, period 2 vs periods 3 and 4, p < 0.01, p < 0.05, respectively). On the other hand, the improvement of decubitus ulcers was associated with a significant reduction in nosocomial pneumonia (period 1 vs. periods 2 and 3, p < 0.05 and p < 0.05, respectively). In conclusion, stringent infection control programs, including a cleaning in the upper airways by povidone iodine, are necessary in geriatric wards to reduce and prevent nosocomial pneumonia.

Topics: Aged; Aged, 80 and over; Cross Infection; Female; Humans; Male; Pneumonia, Bacterial; Povidone-Iodine; Pressure Ulcer; Retrospective Studies

Analysis of the clinical case of a male aged 30 years, presenting with T6 complete paraplegia in 1991, demonstrated the existence of aggravating factors for disuse osteoporosis of spinal cord injury, possibly leading to bone density values below the fracture threshold with the risk of spontaneous fractures. This patient was admitted to hospital for multiple pressure sores requiring prolonged local dressings before and after plastic surgery performed in July 1995. In January 1996, following exercise, he developed a fracture of the femoral diaphysis with a cystic demineralized appearance of the bone. The etiologic work-up demonstrated hyperthyroidism due to iatrogenic iodine overload secondary to Betadine. A review of the literature revealed numerous cases of thyroid dysfunction secondary to iatrogenic iodine saturation. This case justifies regular surveillance of thyroid function tests during prolonged treatment with Betadine and identification of patients with a clinical predisposition.

Topics: Administration, Topical; Adult; Anti-Infective Agents, Local; Bone Density; Femoral Fractures; Fracture Fixation, Intramedullary; Humans; Hyperthyroidism; Iatrogenic Disease; Male; Osteoporosis; Paraplegia; Povidone-Iodine; Pressure Ulcer; Spinal Cord Injuries

Topics: Anti-Infective Agents, Local; Benzoates; Borates; Clinical Protocols; Drug Combinations; Humans; Malates; Povidone-Iodine; Pressure Ulcer; Salicylates; Sodium Hypochlorite

In pressure sore wounds after spinal cord injury, methicillin-resistant Staphylococcus aureus can be detected in 2% of the cases. The elimination of the germ is the aim of the treatment. Pressure sore wounds are an often found complication after spinal cord injury. For local treatment five commercially available antiseptics for the skin and mucous membrane were tested in vitro. The method used is a modified qualitative and quantitative suspension test. The antiseptics were tested without and with addition of 5% albumin in order to simulate the conditions of the wound in vivo. The results show a superior efficacy of the povidone-iodine preparations. Betadine, probably due to the higher concentration, is more efficacious than Braunol; chlorhexidine is sufficiently efficacious without the addition of albumin. These results still have to be confirmed by in vivo studies.

Topics: Anti-Infective Agents, Local; Biguanides; Chamomile; Chlorhexidine; Escherichia coli; Escherichia coli Infections; Flavonoids; Humans; Imines; Iodophors; Methicillin Resistance; Oils, Volatile; Plants, Medicinal; Povidone-Iodine; Pressure Ulcer; Pseudomonas aeruginosa; Pseudomonas Infections; Pyridines; Quaternary Ammonium Compounds; Serum Albumin; Skin; Spinal Cord Injuries; Staphylococcal Infections; Staphylococcus aureus

Povidone-iodine sugar ointment is an excellent preparation for the treatment of decubitus. It has been used as an intrahospital preparation made according to the formula each hospital decided on from experience. Although commercial products have also been developed and used, they are too expensive. The efficacy of a povidone-iodine sugar ointment formulation which can be prepared by a single method and which has the stability and antibacterial activity equal to commercially available products was evaluated. As the test drugs, one commercially available product (UP), and three preparations with different formulas (P-1, P-2 and P-3) were used. All of these test drugs were stored at 20 and 40 degrees C. Specimens were sampled immediately after storage and after 20, 60, 90, 120 and 150 days and examined pharmaceutically (measurement of pH value and determinations of available iodine and sucrose levels). For the determination of bacteriological effects, 5 standard strains of 5 genera and 5 strains of methicillin-resistant Staphylococcus aureus (MRSA) were used and the time required to kill the bacteria was determined. For UP and P-3, no changes were seen pharmaceutically after 150 days of storage at 20 and 40 degrees C. However, MRSA could not be killed within 30 min. P-1 and P-2 showed remarkable changes pharmaceutically after 60 days of storage at 40 degrees C and could not be used any more. It became possible to make a preparation of povidone-iodine sugar ointment which has a stability almost similar to that of UP. Moreover, such a preparation can be made at low cost. However, since the bactericidal activity against MRSA was not higher than those of other drugs, the future task is to improve the bactericidal activity.

Topics: Anti-Infective Agents, Local; Bacteria; Chemistry, Pharmaceutical; Drug Costs; Drug Stability; Drug Storage; Evaluation Studies as Topic; Humans; Hydrogen-Ion Concentration; Iodine; Iodophors; Methicillin Resistance; Ointments; Povidone-Iodine; Pressure Ulcer; Staphylococcus aureus; Sucrose; Temperature; Time Factors

Topics: Humans; Povidone-Iodine; Pressure Ulcer

There are frequent reports of the chronic nature of skin ulcers of varying etiology (burns, bedsores, wound diastasis, etc.); these heal with considerable difficulty probably due to problems related to the excessive use of disinfectants which, in spite of having a good bacterial action, interfere with re-epithelialisation processes. The aim of this study was to assess the value of simple wound cleansing instead of disinfection in those cases where there are no manifest signs of bacterial contamination. A widely sold solution, Katoderm (Devergè, Turin), was used in this study. The study was performed in two stages; the first in laboratory animals and the second in patients with small persistent lesions. The results of the study carried out in rats showed a significant prolongation of healing time in the group treated with polyvinylpyrrolidone-iodine compared to those in which lesions were only cleansed with Katoderm. The results of the clinical study also highlighted the faster speed of healing in patients treated with cleansing alone.

Topics: Administration, Topical; Animals; Burns; Detergents; Humans; Povidone-Iodine; Pressure Ulcer; Rats; Skin Ulcer; Wound Healing

Absorption from povidone-iodine preparations after topical administration has been reported to be negligible, but an elderly woman had increased serum iodine levels with possible metabolic complications after povidone-iodine solution was applied to decubitus ulcers.

Topics: Administration, Topical; Aged; Aged, 80 and over; Female; Humans; Iodine; Povidone; Povidone-Iodine; Pressure Ulcer; Skin Absorption

Topics: Aged; Aged, 80 and over; Female; Humans; Male; Occlusive Dressings; Povidone-Iodine; Pressure Ulcer; Statistics as Topic

Topics: Administration, Topical; Aged; Aged, 80 and over; Drug Therapy, Combination; Humans; Povidone; Povidone-Iodine; Pressure Ulcer; Sucrose

Povidone-iodine (PVP-I) has a wide range of activity against bacteria. The author's clinical experience has indicated that it can be used successfully as a topical agent in the treatment of decubital ulcer in patients with spinal cord injury. To date, 110 patients have been treated with Betadine solution and ointment, topically applied at daily intervals. Of these, 70 patients had decubitus ulcers involving the sacral and trochanter region; 20 were chronic ulcers which cleared up well. Another 20 required rotation grafting procedure. Primary healing was achieved in all patients (1-4).

Topics: Administration, Topical; Adolescent; Adult; Child; Humans; Middle Aged; Povidone; Povidone-Iodine; Pressure Ulcer; Spinal Cord Injuries; Wound Infection

Topics: Administration, Topical; Antacids; Hot Temperature; Humans; Povidone; Povidone-Iodine; Pressure Ulcer

Topics: Humans; Povidone-Iodine; Pressure Ulcer; Surgical Flaps

Seventy-four pressure lesions in fifty-three geriatric patients were observed at weekly intervals to determine the bacterial flora and the healing index of each lesion, expressed as initial area of lesion (cm2) - final area of lesion (cm2) divided by time in days. The micro-organisms which caused infection included Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa, Bacteroides fragilis and Bacteroides asaccharolyticus. Many lesions contained a mixed flora. P mirabilis and Ps aeruginosa were associated with necrotic (p less than 0.005) and enlarging (p less than 5 x 10(-7)) lesions. Bacteroides spp were associated with necrotic lesions (p less than 0.05). The presence of S aureus in a lesion was not associated with any particular trend in healing index. The implications of the microbiological findings are discussed.

Topics: Aged; Female; Humans; Male; Middle Aged; Povidone-Iodine; Pressure Ulcer; Proteus mirabilis; Pseudomonas aeruginosa; Staphylococcus aureus; Wound Healing

The efficacy of topical applications of povidone-iodine (Betadine solution and ointment) for the control of infection associated with decubitus and stasis ulcers was evaluated in 18 male outpatients (age range, 33--68 years). Dressings were changed twice daily over a period of 42 days. Statistically significant improvement was noted in the following signs and symptoms: edema, pain, erythema, ulcer size, and ulcer depth. All patients experienced some degree of symptomatic relief and clinical improvement within two weeks after starting therapy. At the end of the study, 67 percent of the ulcers were clinically cured and 33 percent showed improvement. Acceptance by the patients was excellent, with no reported side effects or sensitization reactions. Povidone-iodine used in a daily regimen of ulcer care can reduce the level of infection and promote healing.

Topics: Administration, Topical; Adult; Aged; Drug Evaluation; Humans; Male; Middle Aged; Povidone; Povidone-Iodine; Pressure Ulcer; Skin Ulcer; Wound Healing

Topics: Adult; Aged; Humans; Male; Middle Aged; Povidone; Povidone-Iodine; Pressure Ulcer