povidone-iodine and Wounds-and-Injuries

Antiseptics, with a broader spectrum of antimicrobial efficacy, lower risk of antibiotic resistance development, and minimal collateral damage to host tissues, are important alternatives to control the bioburden in wounds. Povidone iodine (PVP-I), in use for several decades, has the broadest spectrum of activity, a persistent antimicrobial effect, an ability to penetrate biofilms, and a lack of acquired or cross-resistance. It demonstrates good skin tolerance and low cytotoxicity. However, some reports on PVP-I have raised concerns over allergy, ineffective penetration, and toxic effects on host cells. The majority of these concerns are based on in vitro or rodent wound studies with diverse study designs and outcomes; these results may not be directly applicable in the clinical reality in humans. In this paper, we discuss the efficacy and safety of PVP-I and outline its place in wound healing in Asia, based on an appraisal of recent literature and clinical practice across the region.

Topics: Anti-Infective Agents, Local; Asia; Consensus; Drug Resistance, Bacterial; Humans; Povidone-Iodine; Wound Healing; Wound Infection; Wounds and Injuries

Although complete healing may appear to be the logical goal for most patients and clinicians, some wounds do not have the potential to heal due to a number of factors such as inadequate vasculature, coexisting medical conditions and medications that prohibit the healing process. Local management of wounds that are considered to have poor potential for healing remains elusive. The purpose of this article is to review the evidence that supports the use of topical antiseptic agents in non-healable wounds. Retrospective chart audit was conducted to evaluate the use of povidone iodine in the management of wounds that were deemed to have poor healing potential.

Topics: Administration, Topical; Aged; Anti-Infective Agents, Local; Chronic Disease; Female; Humans; Male; Middle Aged; Povidone-Iodine; Retrospective Studies; Skin Ulcer; Wound Healing; Wounds and Injuries

Infections of contaminated or colonised acute or chronic wounds remain a grave risk for patients even today. Despite modern surgical debridement concepts and antibiotics, a great need exists for new therapies in wound management. Since the late 1990s, advantageous effects of negative pressure wound therapy (NPWT) have been combined with local antiseptic wound cleansing in the development of NPWT with instillation (NPWTi). This article summarises the current scientific knowledge on this topic. MEDLINE literature searches were performed on the subject of negative pressure wound and instillation therapy covering publications from the years 1990 to 2013 (36 peer-reviewed citations) and regarding randomised controlled trials (RCTs) covering wound care with bone involvement (27 publications) or soft-tissue wounds without bone participation (11 publications) from 2005 to 2012. The use of NPWTi in the therapy of infected wounds appears to be not yet widespread, and literature is poor and inhomogeneous. However, some reports indicate an outstanding benefit of NPWTi for patients, using antiseptics such as polyhexanide (concentration 0·005-0·04%) and acetic acid (concentration 0·25-1%) in acute and chronic infected wounds and povidone-iodine (10% solution) as prophylaxis in contaminated wounds with potential viral infection. Soaking times are recommended to be 20 minutes each, using cycle frequencies of four to eight cycles per day. Additionally, the prophylactic use of NPWTi with these substances can be recommended in contaminated wounds that cannot be closed primarily with surgical means. Although first recommendations may be given currently, there is a great need for RCTs and multicentre studies to define evidence-based guidelines for an easier approach to reach the decision on how to use NPWTi.

Topics: Acetic Acid; Anti-Infective Agents, Local; Biguanides; Cross Infection; Evidence-Based Medicine; Humans; Negative-Pressure Wound Therapy; Povidone-Iodine; Surgical Wound Infection; Therapeutic Irrigation; Wound Infection; Wounds and Injuries

Wound care and the use of antiseptics has long been the subject of much debate within the health professional's literature. This study was undertaken to determine the range of literature available on povidone-iodine (PVP-I) antiseptic use and the evidence supporting the outcomes reported. A range of articles was collected and divided into subgroups based on hierarchy of evidence and the five evidence dimensions [1]. Using the READER scoring tool, articles were evaluated and given a numerical award between 4 and 25 as a determinant of their quality in method, statistical analysis and outcome measures, with those scoring 12.5 or higher (from a possible 25) deemed as offering a satisfactory level of evidence. Statistical analysis on the results prior to applying the READER scoring tool found that overall 49% of articles did not support PVP-I use. However, this situation changed when the quality of evidence was limited to articles scoring >12.5. The higher-scored articles showed a 71% support for the continued use of PVP-I. The outcome of this study shows that there is reason for further debate over the use of PVP-I.

Topics: Administration, Topical; Anti-Infective Agents, Local; Evidence-Based Medicine; Humans; Povidone-Iodine; Wound Healing; Wounds and Injuries

For more than 150 years, iodine has been used for the prevention of infection and for the treatment of wounds. Nowadays a large amount of published evidence is available and, although it is generally in support of the use of iodine product, it is confused by being a mixture of laboratory, animals and human studies, often using different preparations. This makes interpretation and comparison difficult. After new developments and publications, the role of iodine in antisepsis and in wound management needs to be reevaluated. We mainly focused our review on the following problems: the role of the newly developed formulations of iodine preparations, its antimicrobial activity, the possibility of impairing the wound healing process, the role of iodine in the problem of growing resistance against antibiotics and antiseptics. New formulations seem to keep the same clinical efficacy, avoiding the problem of toxicity; it seems that the antibacterial activity of iodine is superior compared to other products and, in contrast with antibiotics and other antiseptics, it seems to have no resistance problem. It seems that povidone-iodine has all the characteristics to become the first choice antiseptic in wound treatment.

Topics: Anti-Infective Agents, Local; Antisepsis; Humans; Iodine; Povidone-Iodine; Wounds and Injuries

Dead tissue, in the form of slough and necrosis, can, if present in a wound, delay healing and promote infection. Debridement describes any method by which such materials are removed and, as a consequence, the potential to achieve wound healing enhanced. In this article, the first of two, the author discusses the history of debridement, cell death, the nature of necrotic tissue and a variety of debridement techniques. All methods of debridement have associated risks and benefits and while this article examines its clinical application there are also legal and professional issues to consider particularly in relation to conservative sharp debridement. These issues will be addressed in the second article.

Topics: Anti-Infective Agents, Local; Apoptosis; Bandages; Borates; Debridement; Humans; Hydrogen Peroxide; Necrosis; Povidone-Iodine; Risk Factors; Sodium Hypochlorite; Treatment Outcome; Wound Healing; Wounds and Injuries

Patients with skin injuries account for 15% of accident and emergency (A&E) admissions (Leaman, 1991). Although there is evidence to suggest that wound cleansing is not always necessary (Thomlinson, 1987), no diagnostic test exists to allow healthcare practitioners to identify whether the bacterial load in the wound is capable of causing infection (Chrisholm, 1992). For this reason, all wounds in A&E should undergo some form of cleansing to decrease the bacterial inoculum in the wound to levels that can be managed by host defences (Chrisholm, 1992). Heyworth (1997) postulates that successful management of the contaminated wound must remove contaminants while inflicting minimal injury to tissue. This article reviews the research on the preparation and cleansing of superficial lacerations. Wound closure and indications for oral antibiotics will not be discussed.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Disinfection; Humans; Povidone-Iodine; Sodium Hypochlorite; Therapeutic Irrigation; Wounds and Injuries

Topics: Anti-Infective Agents, Local; Bandages; Dermatitis, Allergic Contact; Dermatitis, Irritant; Humans; Iodine Compounds; Iodophors; Povidone-Iodine; Wound Infection; Wounds and Injuries

For the purpose of providing a summary of current clinical trials to determine whether povidone-iodine is beneficial or detrimental to wound healing, an integrated review was completed. Clinical trials were defined as any study that uses some concentration and form of povidone-iodine in a comparison or evaluation with other products or treatments resulting in an impact of povidone-iodine on wounds. The use of povidone-iodine for cleansing, irrigating, and dressing wounds is controversial. Wound healing is complex and requires safe and effective treatment modalities. Numerous in vitro and in vivo studies have been done with conflicting results on bactericidal effects and cytotoxicity of this antimicrobial agent. Human and animal in vivo studies in the last 10 years were used for this review because often the relevance of in vitro data in clinical conditions are questioned. The varied studies provide evidence that in most instances, povidone-iodine did not effectively promote good wound healing; in fact, most studies showed either impaired wound healing, reduced wound strength, or infection.

Topics: Animals; Anti-Infective Agents, Local; Drug Evaluation, Preclinical; Evidence-Based Medicine; Humans; Povidone-Iodine; Research Design; Skin Care; Wound Healing; Wounds and Injuries

There is a need for cheap and efficacious wound dressings in developing countries. Banana leaves have been described as an excellent, inexpensive, easily available dressing material in tropical countries. As a natural product, banana leaves are heavily contaminated with various pathogens that must be removed before they can be used as wound dressings, but effective sterilization methods that do not affect the beneficial wound-dressing properties of banana leaves have not been described.. To study different sterilization methods and determine which can be used on banana leaves without affecting their beneficial wound-dressing properties.. We first compared the use of different decontamination techniques to reduce the natural microflora of the leaves and then tested the wound-dressing properties of the leaves in a mouse model of skin transplantation and in postsurgical patients in Uganda, Africa.. Steam sterilization proved to be the optimal sterilization technique. Banana leaves displayed wound-dressing properties that equaled those of petroleum jelly gauze dressings and were tested successfully in a clinical setting in postsurgical patients in Uganda, Africa.. We found banana leaves to be an excellent alternative wound dressing, combining the desirable properties of modern wound-dressing material with low cost.

Topics: Animals; Bandages; Developing Countries; Female; Humans; Male; Mice; Musa; Pain Measurement; Plant Leaves; Povidone-Iodine; Sterilization; Uganda; Wounds and Injuries

Chronic wounds represent a major health burden contributing to substantial mortality, morbidity and costs. Several new treatment options are currently available, which has revolutionised the management of chronic wounds. The present study is a single centre, prospective, clinical trial comparing oxum (super oxidised water) and betadine as a topical treatment of chronic wounds conducted in 30 Indian patients, with 15 patients in each group. At the end of the study, there was a significant reduction in primary parameters such as wound area and microbial colony count in oxum treated group compared to betadine group. However, both the oxum and betadine treated group showed a similar results when the secondary parameters such as oedema, erythema and granulation tissue were considered. Oxum was better tolerated than betadine. It can be concluded that use of oxum (super oxidised water) is a novel technological innovation in the therapy of chronic wounds. Oxum has been shown to be effective, well tolerated and superior to betadine in wound care.

Topics: Adult; Analysis of Variance; Anti-Infective Agents, Local; Chronic Disease; Colony Count, Microbial; Female; Health Status Indicators; Humans; Hydrogen Peroxide; Male; Oxidants; Povidone-Iodine; Prospective Studies; Wound Healing; Wounds and Injuries

This prospective, randomised clinical trial compared pain, comfort, exudate management, wound healing and safety with Hydrofiber dressing with ionic silver (Hydrofiber Ag dressing) and with povidone-iodine gauze for the treatment of open surgical and traumatic wounds. Patients were treated with Hydrofiber Ag dressing or povidone-iodine gauze for up to 2 weeks. Pain severity was measured with a 10-cm visual analogue scale (VAS). Other parameters were assessed clinically with various scales. Pain VAS scores decreased during dressing removal in both groups, and decreased while the dressing was in place in the Hydrofiber Ag dressing group (n = 35) but not in the povidone-iodine gauze group (n = 32). Pain VAS scores were similar between treatment groups. At final evaluation, Hydrofiber Ag dressing was significantly better than povidone-iodine gauze for overall ability to manage pain (P < 0.001), overall comfort (P < or = 0.001), wound trauma on dressing removal (P = 0.001), exudate handling (P < 0.001) and ease of use (P < or = 0.001). Rates of complete healing at study completion were 23% for Hydrofiber Ag dressing and 9% for povidone-iodine gauze (P = ns). No adverse events were reported with Hydrofiber Ag dressing; one subject discontinued povidone-iodine gauze due to adverse skin reaction. Hydrofiber Ag dressing supported wound healing and reduced overall pain compared with povidone-iodine gauze in the treatment of open surgical wounds requiring an antimicrobial dressing.

Topics: Adolescent; Adult; Aged; Anti-Infective Agents, Local; Carboxymethylcellulose Sodium; Female; Humans; Male; Middle Aged; Occlusive Dressings; Pain Measurement; Povidone-Iodine; Prospective Studies; Silver Sulfadiazine; Wound Healing; Wounds and Injuries

Different povidone/iodine (PI) dosage forms (e.g. solution, ointment, gel) in various PI concentrations and percentage of water were prepared. The efficacy of these formulations was assessed in vitro bacteriologically and clinically in large number of human and animal subjects. Comparison of their effect with those of other agents in some cases was made. The results obtained indicated that the antibacterial activity of PI in different formulation types was in the order: aqueous solution > water soluble ointment base containing 20% (w/w) water > aqueous gel base > water soluble ointment base containing 10% (w/w) water > water soluble ointment base > oleaginous base. PI is more efficient when comparing it with some conventional antiseptics, used clinically, and enhances wound healing process.

Topics: Animals; Bacteria; Camelus; Cattle; Cattle Diseases; Dosage Forms; Gels; Horse Diseases; Horses; Humans; Microbial Sensitivity Tests; Ointments; Povidone-Iodine; Wound Healing; Wounds and Injuries

In a prospective, controlled, clinical trial, we found that preoperative showering and scrubbing with 4% chlorhexidine gluconate was more effective than povidone-iodine or triclocarban medicated soap in reducing skin colonization at the site of surgical incision. Mean log colony counts of the incision site were one half to one log lower for patients who showered with chlorhexidine compared to those who showered with the other regimens. No growth was observed on 43% of the post shower skin cultures from patients in the chlorhexidine group compared with 16% of the cultures from patients who had povidone-iodine showers and 5% of those from patients who used medicated soap and water. The frequency of positive intraoperative wound cultures was 4% with chlorhexidine, 9% with povidone-iodine and 14% with medicated soap and water. This study demonstrates that chlorhexidine gluconate is a more effective skin disinfectant than either povidone-iodine or triclocarban soap and water and that its use is associated with lower rates of intraoperative wound contamination.

Topics: Baths; Carbanilides; Chlorhexidine; Clinical Trials as Topic; Double-Blind Method; Female; Hand Disinfection; Humans; Intraoperative Complications; Male; Povidone-Iodine; Preoperative Care; Prospective Studies; Skin; Surgical Wound Infection; Wounds and Injuries

A prospective, randomized study of 500 consecutive emergency department patients with traumatic lacerations requiring sutures was performed comparing use of topical 1% povidone-iodine (Betadine) and scrubbing with wound management by irrigation with normal saline without scrubbing. A 60-second wound irrigation and scrub with a 1% povidone-iodine solution was the only difference in treatment between the two groups. Data relating to risk factors such as age; degree of contamination; type of closure; ethanol intoxication; mechanism of injury; and bone, joint, or tendon involvement were analyzed. Wounds were classified as clean, infected, or purulent at follow-up examination. One hundred five patients were lost to follow-up. Of the 395 remaining patients, 122 were contacted by phone and were classified based on their description of the wound; 273 were classified at reexamination in the ED. Of 201 povidone-iodine group wounds, 11 became infected; two of them (5.4%) were purulent. Of 194 control wounds, 30 became infected, of which 12 (15.46%) were purulent (P less than .01). These data suggest that use of a topical 1% povidone-iodine solution in traumatic lacerations prior to suturing reduces the incidence of wound infections.

Topics: Adult; Emergencies; Humans; Povidone; Povidone-Iodine; Prospective Studies; Random Allocation; Sodium Chloride; Sutures; Wound Infection; Wounds and Injuries

Topics: Adolescent; Adult; Aerosols; Aged; Child; Child, Preschool; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Povidone; Povidone-Iodine; Sutures; Wound Infection; Wounds and Injuries

The effect of dry powder povidone-iodine (Disadine D.P.) on wound healing was assessed experimentally and clinically. It did not interfere with wound healing macroscopically, histologically or mechanically in Wistar rats. One hundred and one patients undergoing 'clean' elective surgery were included in the controlled clinical study and povidone-iodine did not affect wound healing in any way. In the control group 4% of patients developed infection compared with none of those sprayed with povidone-iodine. No adverse reaction to povidone-iodine was seen in either study. This antiseptic offers a safe alternative to antibiotics for use at operation whenever there is risk of wound infection from operative bacterial contamination.

Topics: Abdomen; Animals; Clinical Trials as Topic; Female; Humans; Povidone; Povidone-Iodine; Rats; Surgical Wound Infection; Wound Healing; Wounds and Injuries

Bacterial nanocellulose (BNC) is considered a promising carrier for various substances and novel approaches using BNC in combination with antiseptics are well documented. However, the difference in the molecular weight of these molecules influences their uptake by and release from BNC. Analysing the diffusion of standard molecules with different weight, e.g. dextrans, offers the possibility to investigate the mobility of various molecules. We aimed to test the use of BNC regarding uptake and release of different standard molecules as well as two commercially available antiseptics for possible applications in future wound dressings.. Diffusion profiles, uptake and release of three FITC-dextran molecules differing in weight as well as octenidine (Octenisept®) and povidone-iodine (Betaisodona®)-based antiseptics were tested with BNC-based wound dressings. Furthermore, the antiseptic efficacy of BNC in combination with antiseptics against Staphylococcus aureus was tested.. Uptake and release capacity for FITC-dextran molecules showed a molecular weight-dependent mobility from BNC into an agarose gel. The loading capacity of BNC was also inversely proportional to the molecular weight of the antiseptics. The release test for octenidine showed a sustained and prolonged delivery into a solid matrix, whereas povidone-iodine was released faster. Both antiseptic solutions combined with BNC showed a good dose-dependent efficacy against S. aureus.. Results obtained from the mobility of FITC-dextran molecules in the BNC matrix could open possible applications for the combination of BNC with other molecules for medical applications. Combination of both tested antiseptics with BNC showed to be an efficient approach to control bacterial infections.

Topics: Anti-Infective Agents, Local; Bandages; Burns; Cellulose; Dextrans; Drug Carriers; Fluorescein-5-isothiocyanate; Humans; Imines; Molecular Weight; Nanostructures; Povidone-Iodine; Pyridines; Wound Infection; Wounds and Injuries

Chronic skin wounds are usually colonised with bacteria and subsequent infection may develop. Topical antiseptics are commonly used to control bacterial colonisation. The topical antiseptic, 1% polyvinylpyrrolidone-iodine (PVP-I), that is used on chronic open skin wounds remains controversial in the clinical setting because of its cytotoxicity. Here, we tested 1% PVP-I solution against saline to determine if it reduces bacterial count on the wound surface and within the tissue that may lead to wound reduction.. Open wounds that were created on the backs of Sprague Dawley rats were inoculated with Pseudomonas aeruginosa at the wound surface. Wounds were kept covered except for wound irrigation, two days post-wounding, wounds were irrigated daily using a 10ml syringe and spray tip.. Our results indicate that 1% PVP-I irrigation resulted in a reduced bacterial count on the wound surface and within the tissue compared with saline irrigation. The 1% PVP-I irrigation promoted wound re-epithelialisation compared with saline irrigation, but it did not reach significance.. These results indicated that irrigation with 1% PVP-I was an effective way to reduce bacterial count on the wound surface, and allow the wound to progress to healing.

Topics: Animals; Anti-Infective Agents, Local; Bacterial Load; Biofilms; Male; Povidone-Iodine; Pseudomonas aeruginosa; Rats; Rats, Sprague-Dawley; Sodium Chloride; Therapeutic Irrigation; Wounds and Injuries

A flexible methacrylate powder dressing (Altrazeal®) transforms into a wound contour conforming matrix once in contact with wound exudate. We hypothesised that it may also serve as a drug delivery vehicle for antiseptics. The antimicrobial efficacy and influence on bacterial growth kinetics in combination with three antiseptics was investigated in an in vitro porcine wound model. Standardized in vitro wounds were contaminated with Staphylococcus aureus (MRSA; ATCC 33591) and divided into six groups: no dressing (negative control), methacrylate dressing alone, and combinations with application of 0.02% Polyhexamethylene Biguanide (PHMB), 0.4% PHMB, 0.1% PHMB + 0.1% betaine, 7.7 mg/mL Povidone-iodine (PVP-iodine), and 0.1% Octenidine-dihydrochloride (OCT) + 2% phenoxyethanol. Bacterial load per gram tissue was measured over five days. The highest reduction was observed with PVP-iodine at 24 h to log10 1.43 cfu/g, followed by OCT at 48 h to log10 2.41 cfu/g. Whilst 0.02% PHMB resulted in a stable bacterial load over 120 h to log10 4.00 cfu/g over 120 h, 0.1% PHMB + 0.1% betaine inhibited growth during the first 48 h, with slightly increasing bacterial numbers up to log10 5.38 cfu/g at 120 h. These results indicate that this flexible methacrylate dressing can be loaded with various antiseptics serving as drug delivery system. Depending on the selected combination, an individually shaped and controlled antibacterial effect may be achieved using the same type of wound dressing.

Topics: Animals; Anti-Infective Agents, Local; Bandages; Betaine; Biguanides; Disinfectants; Drug Delivery Systems; Drug Synergism; Ethylene Glycols; Imines; Kinetics; Methicillin-Resistant Staphylococcus aureus; Povidone-Iodine; Pyridines; Swine; Time Factors; Wound Healing; Wounds and Injuries

Selecting an appropriate treatment for a given case of skin wound is crucial for inducing optimal healing. We used an animal model developed from normal rabbit ears in order to assess the efficacy of treatments for skin wounds with or without a wet dressing, anti microbial reagent or topical wound-stimulatory reagents. The degree of healing in each group was evaluated and compared using four histological parameters: (i) degree of reepithelialisation, (ii) amount of granulation tissue formation, and (iii) the number of capillary lumens and (iv) fibroblasts in the granulation tissue. Treatment using wet dressings resulted in an increase in capillary number compared with the open dry wound. Although the retention of povidone-iodine (PI) in wound tissue after application significantly inhibited reepithelialisation (P < 0.05), rinsing PI off with saline was comparable in effect to using only a wet dressing. The three topical reagents, namely, basic fibroblast growth factor, prostaglandin E1 and dibutyryl cyclic adenosine monophosphate, significantly improved reepithelialisation (P < 0.05). In conclusion, wounds should be kept hydrated by applying topical reagents. If there are any signs of bacterial infection, PI can be applied and rinsed later with saline in order to minimise its cytotoxic effects.

Topics: Alprostadil; Animals; Anti-Infective Agents, Local; Bucladesine; Disease Models, Animal; Drug Therapy, Combination; Ear; Female; Fibroblast Growth Factor 2; Fibroblasts; Granulation Tissue; Povidone-Iodine; Rabbits; Skin; Vasodilator Agents; Wound Healing; Wounds and Injuries

To compare the tissue tolerance and efficacy of two wound antiseptics with tissue-tolerable plasma (TTP) on enucleated contaminated eyes from slaughtered pigs in order to draw consequences for the use of TTP on wounds.. The corneas of extracted eyes were contaminated with Staphylococcus aureus or Pseudomonas aeruginosa. One and 10 min after application of 10% povidone (PVP)-iodine and 0.04% polyhexanide, respectively, the eyes were rinsed with inactivating solution. To test TTP, the plasma pen meandered over the eyes at a speed of 30 mm/s and a distance of 5 mm; the eyes were then rinsed with balanced salt solution. The reduction factor was calculated by the difference between the logarithm of colony-forming units in the rinse before and after antisepsis or TTP application.. The efficacy of TTP (reduction factor 2.4-2.9) was significantly higher (p < 0.001) than that of PVP-iodine and polyhexanide (reduction factor 1.7-2.1).. TTP is more effective than the tested wound antiseptics. The lack of histological damage to the eyes of slaughtered pigs would seem to make its use as a wound antiseptic a viable alternative. In contrast to antiseptics, it supplies additional energy in the form of heat, electric fields and radicals by TTP.

Topics: Animals; Anti-Infective Agents, Local; Antisepsis; Bacteria; Biguanides; Colony Count, Microbial; Cornea; Plasma Gases; Povidone-Iodine; Pseudomonas aeruginosa; Staphylococcus aureus; Swine; Wounds and Injuries

This work describes the design and assembly of multifunctional and cost-efficient composite fiber nonwovens as semi-occlusive wound dressings using a simple electrospinning process to incorporate a variety of functional components into an ultrathin fiber. These components include non-hydrophilic poly(L-lactide) (PLLA) as fibrous backbone, hydrophilic poly(vinyl pyrrolidone)-iodine (PVP-I), TiO(2) nanoparticles, zinc chloride as antimicrobial, odor-controlling, and antiphlogistic agents, respectively. The process of synthesis starts with a multicomponent solution of PLLA, PVP, TiO(2) nanoparticles plus zinc chloride, in which TiO(2) nanoparticles are synthesized by in situ hydrolysis of TiO(2) precursors in a PVP solution for the sake of obtaining the particle-uniformly dispersive solution. Subsequent electrospinning generates the corresponding composite fibers. A further iodine vapor treatment to the composite fibers combines iodine with PVP to produce the PVP-I complexes. Experiments indicate that the assembled composite fibers (300-400 nm) possess the ointment-releasing characteristic and the phase-separate, core-sheath structures in which PVP-I residing in fiber surface layer becomes the sheath, and PLLA distributing inside the fiber acts as the core. Based on this design, the structural advantages combining active components endow the assembled composite nonwovens with a variety of functions, especially, the existence of PVP-I, endows the nonwoven with water absorbability, antimicrobial activity, adhesive ability, and transformable characteristic from hydrophilicity to non-hydrophilicity. The multifunctional, cost-efficient, and ointment-releasing characteristics make the multicomponent composite fibrous nonwovens potentially useful in applications such as initial stage of dressing of the cankerous or contaminated wounds.

Topics: Absorption; Anti-Bacterial Agents; Escherichia coli; Materials Testing; Microbial Sensitivity Tests; Microscopy, Electron, Scanning; Occlusive Dressings; Odorants; Ointments; Porosity; Povidone-Iodine; Spectrophotometry, Ultraviolet; Spectroscopy, Fourier Transform Infrared; Spectrum Analysis, Raman; Staphylococcus aureus; Water; Wounds and Injuries

Minimum bactericidal concentrations (MBCs) of seven biocides for 42 methicillin-resistant Staphylococcus aureus (MRSA) isolates at 5, 30, or 180 min, for hand scrubs or soaks, isolated in 2003 in Japan were determined. The MBC values of glutaraldehyde, povidone iodine, and ethanol were lower than the user concentrations in all exposure times. However, at 5 min exposure of sodium hypochlorite, benzalkonium chloride, alkyldiaminoethylglycine hydrochloride, and chlorhexidine digluconate some strains showed higher MBC values than the user concentrations. These results indicated the possibility that MRSA survived under proper user concentration conditions and exposure time.

Topics: Benzalkonium Compounds; Chlorhexidine; Disinfectants; Ethanol; Female; Glutaral; Hand; Hand Disinfection; Humans; Male; Methicillin Resistance; Microbial Sensitivity Tests; Mucous Membrane; Phylogeny; Povidone-Iodine; Sodium Hypochlorite; Staphylococcus aureus; Time Factors; Urine; Wounds and Injuries

To determine toxicity indexes of commercially available skin, wound, and skin/wound cleansers on in vitro fibroblasts and keratinocytes.. Seventeen cleansers and 3 liquid bath soaps were evaluated for cytotoxic effect on human infant dermal fibroblasts and epidermal keratinocytes. Both skin cell types were exposed to serial 10-fold dilutions of each cleanser until treated cell viability was comparable to untreated controls.. The experimental design allowed calculation of relative toxicity indexes ranging from 0 to 100,000. Shur-Clens, SAF-Clens, and saline were found to be the least toxic to fibroblasts (toxicity index 0); Dial Antibacterial Soap and Ivory Liqui-Gel were the most toxic (toxicity index 100,000). Biolex, Shur-Clens, and Techni-Care were the least toxic to keratinocytes (toxicity index 0); hydrogen peroxide, modified Dakin's solution, and povidone (10%) were found to be the most toxic (toxicity index 100,000).. Successful cutaneous tissue repair depends on the viability of the principal cell types involved (fibroblasts and keratinocytes). Toxicity indexes provide helpful guidelines for subsequent in vivo evaluations and clinical applications. The study findings also suggest that judicious use of these supposedly innocuous agents should be considered in a clinical setting.

Topics: Acetic Acid; Anti-Infective Agents, Local; Benzethonium; Boric Acids; Cell Culture Techniques; Cell Survival; Cells, Cultured; Drug Combinations; Drug Evaluation, Preclinical; Fibroblasts; Humans; Hydrogen Peroxide; Infant; Keratinocytes; Povidone-Iodine; Skin Care; Soaps; Sodium Bicarbonate; Sodium Chloride; Sodium Hypochlorite; Toxicity Tests; Wound Healing; Wounds and Injuries

Topics: Administration, Topical; Disinfectants; Drug Combinations; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate; Povidone-Iodine; Wound Healing; Wound Infection; Wounds and Injuries

Cytotoxic effect and guinea pig wound cure stage, pus fabrication presence in infected wound were compared with strong acidic electrolyzed water (AcEW) and povidone-iodine solution (PVP-I), chlorhexidine (CHG) and benzalkonium chloride (BAC). It gave the following results: In a cytotoxic test, the toxicity was recognized in 0.1%-0.01% PVP-I, in 0.0002-0.0004% CHG, in 10-0.1 micrograms/ml BAC, but there was no toxicity in AcEW. By a guinea pig wound cure process, no significance was recognized between each pharmaceutical agent in epidermal cell migration, but by an inflammation locus area, the significance was considerable in comparison with no-treatment. The pyopoiesis of P. aeruginosa infected wound was recognized in a ratio of 38.2% physiological saline, 27.3% CHG, 20.6% PVP-I and 12.1% AcEW. When pollution locus includes an infection image of bacteria, while draining AcEW instead of physiological saline, disinfection, indication was expected, and, as for the disorder in cure stage. I do not agree with that mentioned above. As for AcEW, availability by organism use was recognized for the cytotoxic effect of antiseptic instead of action of acceleration for wound cure.

Topics: Animals; Anti-Infective Agents, Local; Benzalkonium Compounds; Chlorhexidine; Colony Count, Microbial; Drug Resistance, Bacterial; Female; Guinea Pigs; Klebsiella pneumoniae; Povidone-Iodine; Pseudomonas aeruginosa; Solutions; Wounds and Injuries

Cytotoxicity and effect on guinea pig wounds were compared with three kinds of 10% povidone-iodine solution (isodine, neojodine, J-iodine) and povidone-iodine. It gave the following results: 1. In the Chang conjunctiva cell where remarkable toxicity was observed in the used cell line, the toxicity emphasized was 10 times using povidone-iodine < J-iodine < neojodine < isodine. In addition, a toxic difference was recognized between cells, in the order of Chang conjunctiva > SIRC > FRSK > human fibroblast for isodine and neojodine. 2. As for the influence on cells achromatized in sodium thiosulfate, alteration was not recognized in isodine, J-iodine using half-maximum cytotoxicity concentrations (CC50), and, in neojodine and povidone-iodine, elimination of drug toxicity was recognized in Chang conjunctiva/FRSK cells. 3. Strong toxicity was seen in isodine and neojodine in the toxicity test using colony formation method, however on washing with PBS (-), an easing of the toxicity effect could be seen to 0.01%. 4. Polyoxythylene nonylphenyl ether, NP-10 was the most toxic in the used surfactants in this study, and the toxicity by 100 times when compared with sodium polyoxyethylene lauryl ether sulfate, SBL-2N. Prominent sensitivity was observed in Chang conjunctiva cells with regard to the cell line and subsequently showed toxicity in order of SIRC > FRSK > human fibroblast. Remarkably, the difference between solutions of isodine and J-iodine was made more clear from the 5th culture. 5. In this study, significantly guinea pig wounds, povidone-iodine blocked all examples significantly recognized as dallying by distance between epidermal cells. In addition, isodine was meaningful area. Although their ware not offer the significant differences, the solutions obstructed the sliding of epidermal cells in comparison with povidone-iodine, and a delaying tendency of inflammation was also recognized. The toxic difference between povidone iodine solutions was regarded as the influence of surfactants added to the povidone-iodine. Based on this foundation study, more detailed clinical testing is necessary in determine where sterilization to wounds/mucosa/eyes with solutions containing additive is a suitable panpractice or not.

Topics: Animals; Conjunctiva; Dendritic Cells; Guinea Pigs; Povidone-Iodine; Surface-Active Agents; Wounds and Injuries

Irrigating wounds with solutions of antiseptic or antibiotic agents is routinely performed in orthopaedic surgery to reduce the incidence of microbial infection. The effects of these agents on healthy bone tissue is unknown. Three commonly employed antiseptic agents (hydrogen peroxide, Betadine solution, Betadine scrub) and one antibiotic solution (bacitracin) were tested on tibiae and osteoblasts isolated from embryonic chicks. Osteoblast function was evaluated by glycolytic energy metabolism (lactate production), cell number (DNA content), and collagen synthesis ([3H]proline hydroxylation). Two series of experiments were performed. To study concentration-related effects, tibiae or cells were exposed to a range of concentrations of the agents (diluted in saline, 0.9% NaCl) for 2 min, rinsed with saline, and incubated for 24 h in medium containing [3H]proline. For the recovery study, the cells were exposed to an effective, but nonlethal, concentration of the antiseptic agents for 2 min, rinsed with saline, and the incubation was continued in complete culture medium for 6, 12, 24, 48, or 72 h with [3H]proline added for the final 6 h. Solutions containing the antiseptic agents were cytotoxic to both bones and cells at concentrations well below those used clinically in irrigation solutions. In contrast, bacitracin at the concentrations tested was safe for osteoblasts and tibiae. These results suggest that the use of irrigation solutions containing H2O2, Betadine solution, or Betadine scrub on exposed bone tissue should be considered with caution.

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacitracin; Cells, Cultured; Chick Embryo; Osteoblasts; Povidone-Iodine; Therapeutic Irrigation; Tibia; Wounds and Injuries

Topics: Humans; Povidone-Iodine; Wound Healing; Wounds and Injuries

Topics: Age Factors; Aged; Animals; Disease Models, Animal; Humans; Povidone-Iodine; Wound Healing; Wounds and Injuries

Topics: Animals; Bandages; Drug Evaluation; Humans; Povidone-Iodine; Wound Healing; Wounds and Injuries

Abrasions in cyclists were either treated with an occlusive hydrocolloid dressing or with tulle gauze. The main object of the study was to investigate practical questions, e.g: Could the cyclists go on racing without their injuries impeding their progress? Medical aspects evaluated in the study were: the healing time and the infection rate of the wounds. Twenty-three racing cyclists with 38 abrasions were treated with a hydrocolloid dressing and 41 abrasions in 24 cyclists with tulle gauze. The results of the study show that the occlusive dressing produces a shorter healing time (5.6 days) than the tulle gauze (8.9 days), with smaller risks of infection (0% and 10%, respectively) and a longer wearing period per dressing. The hydrocolloid dressing also gives more pain relief than the tulle gauze (91% no pain during racing with the hydrocolloid dressing, 30% with the tulle gauze) and a higher overall comfort (very comfortable to comfortable versus uncomfortable to moderately uncomfortable, respectively).

Topics: Adolescent; Adult; Bandages, Hydrocolloid; Bicycling; Colloids; Female; Humans; Male; Occlusive Dressings; Povidone-Iodine; Wound Healing; Wound Infection; Wounds and Injuries

Topics: Humans; Povidone-Iodine; Wound Healing; Wounds and Injuries

In this report the possibilities for the application of PVP-iodine-preparations in the developing countries in the treatment of wounds, including burns and in diseases of the mucous membrane, eyes, mouth and genital region are discussed. The application proved particularly valuable where a high antibiotic resistance was found.

Topics: Atlantic Islands; Burns; Chemical Phenomena; Chemistry; Eye Diseases; Humans; Povidone; Povidone-Iodine; Skin Diseases, Infectious; Sudan; Surgical Wound Infection; Wound Infection; Wounds and Injuries

Topics: Humans; Povidone; Povidone-Iodine; Wounds and Injuries

Topics: Fibroblasts; Humans; Hydrogen Peroxide; Povidone; Povidone-Iodine; Wounds and Injuries

Topics: Humans; Povidone; Povidone-Iodine; Statistics as Topic; Wounds and Injuries

We studied the ability of a polyethylene oxide hydrogel dressing (Vigilon) containing povidone-iodine to prevent Staphylococcus aureus proliferation in partial-thickness wounds. We previously reported that a single application of povidone-iodine on wounds challenged with 2 X 10(6) S aureus was not effective in reducing the number of S aureus after 24 hours. It was therefore hypothesized that povidone-iodine might be effective if it was available continuously and applied to wounds containing a smaller number of bacteria. To test this hypothesis, we made multiple partial-thickness wounds (5 X 7 X 0.3 mm) on six domestic pigs. We then inoculated the wounds by scrubbing them with either a low concentration (log 3.5) or a high concentration (log 7) of S aureus suspension. The wounds were either treated with Vigilon or Vigilon containing povidone-iodine or left air exposed. Wounds from each of these treatment groups were cultured by the scrub technique for S aureus with a 0.5% sodium thiosulfate-polysorbate (Tween) 80 solution 5 minutes, 30 minutes, 24 hours, or 48 hours later. A significant reduction in the number of S aureus recovered from wounds treated with Vigilon containing povidone-iodine was seen with the group inoculated with a low bacterial concentration after 24 hours; but no reductions were observed when wounds were inoculated with the higher bacterial concentration of log 7. We found Vigilon containing povidone-iodine to be an effective inhibitor of S aureus in wounds over a 24-hour period when the organism was present in low numbers.

Topics: Animals; Dose-Response Relationship, Drug; Occlusive Dressings; Polyethylene Glycols; Povidone; Povidone-Iodine; Staphylococcus aureus; Swine; Wounds and Injuries

Topics: Antisepsis; Humans; Povidone; Povidone-Iodine; Premedication; Preoperative Care; Surgical Procedures, Operative; Surgical Wound Infection; Wound Infection; Wounds and Injuries

Topics: Bandages; Humans; Povidone; Povidone-Iodine; Wounds and Injuries

The efficiency of four commonly used antiseptics, chlorhexidine, povidone-iodine, cetrimide and sodium hypochlorite was compared in the disinfection of silicone-foam dressing used in the management of open granulating wounds. An in vitro model was first used to determine the minimum effective concentration of each antiseptic in killing a standard culture of Pseudomonas. The appropriate concentrations were then compared in comparative studies of clinical wounds. Chlorhexidine proved to be the most effective antiseptic, povidone-iodine and cetrimide were moderately successful, but sodium hypochlorite gave poor results. A subsidiary study looked at the problem of wound irritation by carry-over of the antiseptic. A rinse of the dressing after disinfection prevented irritation by chlorhexidine without compromising its antibacterial effect, but this procedure sometimes failed to prevent irritation when using the other antiseptic agents. It is concluded that chlorhexidine is the preferred cleansing agent in the management of silicone-foam dressings on both grounds of bacteriological efficiency and lack of wound irritation. It should be noted that Hibitane concentrate used in this work contains non-ionic detergent and a stabilizing agent. Pure preparations of chlorhexidine may not behave similarly.

Topics: Anti-Infective Agents, Local; Bandages; Cetrimonium; Cetrimonium Compounds; Chlorhexidine; Disinfection; Humans; Models, Biological; Povidone-Iodine; Pseudomonas aeruginosa; Silicones; Sodium Hypochlorite; Sterilization; Wounds and Injuries

Over a 56-month period (January 1976 to August 1980), we treated 605 patients for wounds, burns, and ulcers with granulated sugar and povidone-iodine. Rapid healing ensued, due to a reduction in bacterial contamination, rapid debridement of eschar, probable nourishment of surface cells, filling of defects with granulation tissue, and covering of granulation tissue with epithelium. The requirements for skin grafting and antibiotics were greatly reduced, as were hospital costs for wound, burn, and ulcer care.

Topics: Adolescent; Adult; Aged; Burns; Drug Combinations; Female; Humans; Male; Middle Aged; Povidone; Povidone-Iodine; Sucrose; Ulcer; Wound Healing; Wounds and Injuries

Topics: Anti-Infective Agents, Local; Burns; Humans; Povidone; Povidone-Iodine; Skin Ulcer; Surgical Wound Infection; Wounds and Injuries

Topics: Humans; Male; Middle Aged; Povidone; Povidone-Iodine; Skin Diseases, Vesiculobullous; Therapeutic Irrigation; Wounds and Injuries

Acetic acid, hydrogen peroxide, and povidone-iodine solutions were applied to experimental wounds in rats and to human donor sites to test their effects on wound healing. Control donor sites were treated with saline or dry Owens gauze. The acetic acid and povidone-iodine solutions had no significant gross or microscopic effect on the wounds. The hydrogen peroxide solution seemed to hasten the separation of the scab and to shorten the healing time, though characteristic bullae and ulceration appeared if the hydrogen peroxide treatment was applied after the crust had separated, when new epithelium was visible. We believe that the use of hydrogen peroxide should be avoided after crust separation. When only dry Owens gauze was used to treat split-skin graft donor areas, the result was a 3-day prolongation of the scab separation (compared to the saline controls) and greater subepidermal reactive and inflammatory changes.

Topics: Acetates; Animals; Anti-Infective Agents, Local; Antisepsis; Blister; Humans; Hydrogen Peroxide; Povidone-Iodine; Rats; Skin Transplantation; Sodium Chloride; Time Factors; Transplantation, Autologous; Wound Healing; Wounds and Injuries

Topics: Clostridium Infections; Female; Humans; Male; Ointments; Povidone; Povidone-Iodine; Wound Infection; Wounds and Injuries

Topics: Burns; Humans; Povidone; Povidone-Iodine; Preoperative Care; Surgical Wound Infection; Wounds and Injuries

Topics: Anti-Infective Agents, Local; Burns; Drug Therapy; Halogens; Humans; Hydrocarbons, Halogenated; Povidone-Iodine; Skin Diseases; Wounds and Injuries