Bactericidal activity and toxicity of iodine-containing solutions in wounds
G. Rodeheaver, W. Bellamy, M. Kody, G. Spatafora, L. Fitton, K. Leyden and R. Edlich
Complexing iodine with povidone (polyvinylpyrrolidone) or surfactants
significantly limits the quantity of free iodine. Reduction of the free
iodine level eliminates the adverse properties of staining, instability,
and irritation and also alters bactericidal activity. Addition of
detergents to create surgical scrub solutions further reduces the activity
of iodine. In vitro testing indicated that the bactericidal activity of
iodophors was inferior to that of uncomplexed aqueous iodine. In vivo tests
proved that aqueous iodine significantly potentiated the development of
infection. Although the povidone iodophor did not enhance the rate of wound
or infection, it offered no therapeutic benefit when compared with control
wounds treated with saline solution. Addition of detergents to the povidone
iodophor was deleterious, with the wounds exposed to this combination
displaying significantly higher infection rates than untreated control
wounds. Based on these results, aqueous iodine solutions and iodophor
surgical scrub solutions should not be used on broken skin. Aqueous
iodophors can be used in wounds, but no therapeutic benefit from such use
was found in this study.
