povidone-iodine and Rupture--Spontaneous

The purpose of this work was to compare the efficacy and safety of the collagen-gentamicin sponge with conventional treatment (wound open, maintaining a close observation, and cleaning it daily with antiseptics) for the prophylaxis of infection in "dirty" abdominal wounds. Seventy-three patients with dirty abdominal wounds caused by gastrointestinal tract surgery were studied. The patients were randomized in two groups: group A, open wounds, treated with local cleansing, metronidazole 20 to 40 mg/kg/day IV and gentamicin 5 mg/kg/day IV for 7 days. Group B, primary closure with collagen-gentamicin implant plus metronidazole 20 to 40 mg/kg/day IV for 7 days. Surgical wound infections were significantly reduced by the collagen-gentamicin implant. Polymicrobial infections were observed in group A, whereas the infections were caused only by a single organism in group B. In conclusion, the collagen-gentamicin implant is effective and well tolerated in the treatment of "dirty" surgical abdominal wounds because it significantly reduces the wound infection rate (p < 0.01) and shortens healing time (p < 0.001) and the period of disability.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Appendicitis; Bacterial Infections; Collagen; Colonic Diseases; Drug Implants; Female; Gallbladder Diseases; Gelatin Sponge, Absorbable; Gentamicins; Humans; Intestinal Perforation; Male; Metronidazole; Middle Aged; Povidone-Iodine; Rupture, Spontaneous; Surgical Wound Infection; Wound Healing

The aim of this case study is to present effectiveness of percutaneous drainage as a treatment option of ruptured lung and liver hydatid cysts. A 65-year-old male patient was admitted with complicated liver and lung hydatid cysts. A liver hydatid cyst had ruptured transdiaphragmatically, and a lung hydatid cyst had ruptured both into bronchi and pleural space. The patient could not undergo surgery because of decreased respiratory function. Both cysts were drained percutaneously using oral albendazole. Povidone-iodine was used to treat the liver cyst after closure of the diaphragmatic rupture. The drainage was considered successful, and the patient had no recurrence of signs and symptoms. Clinical, laboratory, and radiologic recovery was observed during 2.5 months of catheterization. The patient was asymptomatic after catheter drainage. No recurrence was detected during 86 months of follow-up. For inoperable patients with ruptured liver and lung hydatid cysts, percutaneous drainage with oral albendazole is an alternative treatment option to surgery. The percutaneous approach can be life-saving in such cases.

Topics: Aged; Albendazole; Anticestodal Agents; Bronchial Fistula; Combined Modality Therapy; Diaphragm; Drainage; Echinococcosis, Hepatic; Echinococcosis, Pulmonary; Humans; Male; Pleural Effusion; Povidone-Iodine; Rupture, Spontaneous; Sclerotherapy; Therapeutic Irrigation; Tomography, X-Ray Computed; Ultrasonography

A study conducted into 91 appendectomised patients revealed wound infection rates to worsen from eight to 26 per cent (p less than 0.05) in the wake of locally delimited intra-operative application of povidone-iodine solution, two per cent in concentration. No other factors were found to be responsible for that aggravation. Tissue toxicity was found to outweight bactericidal effects, even with application in diluted and PVP-bonded form. Hence, povidone-iodine solutions not even in diluted form should ever be applied to wound treatment.

Topics: Adult; Appendectomy; Appendicitis; Female; Humans; Intestinal Perforation; Male; Peritoneal Lavage; Povidone; Povidone-Iodine; Rupture, Spontaneous; Surgical Wound Infection