Evaluation of the role of povidone‑iodine in the prevention of surgical site infections.
Antiseptic
Decolonization
Povidone‑iodine
Surgical site infection
Wound healing
Journal
Surgery open science
ISSN: 2589-8450
Titre abrégé: Surg Open Sci
Pays: United States
ID NLM: 101768812
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
19
12
2022
revised:
09
03
2023
accepted:
11
03
2023
medline:
11
4
2023
entrez:
10
4
2023
pubmed:
11
4
2023
Statut:
epublish
Résumé
The occurrence of surgical site infections (SSIs) is associated with increased risk of mortality, development of other infections, and the need for reintervention, posing a significant health burden. The aim of this review was to examine the current data and guidelines around the use of antiseptic povidone‑iodine (PVP-I) for the prevention of SSIs at each stage of surgical intervention. A literature search for selected key words was performed using PubMed. Additional papers were identified based on author expertise. Scientific evidence demonstrates that PVP-I can be used at every stage of surgical intervention: preoperative, intraoperative, and postoperative. PVP-I is one of the most widely used antiseptics on healthy skin and mucous membranes for preoperative surgical site preparation and is associated with a low SSI rate. For intraoperative irrigation, aqueous PVP-I is the recommended agent and has been demonstrated to decrease SSIs in a range of surgical settings, and for postoperative wound healing, there is a growing body of evidence to support the use of PVP-I. There is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation. The use of a single agent (PVP-I) at each stage of surgical intervention could potentially provide advantages, including economic benefits, over agents that can only be used at discrete stages of the surgical procedure. Evidence supports the use of PVP-I at all stages of surgical intervention, from preoperative measures (including skin preparation, preoperative washing, and nasal decolonization) to intraoperative irrigation, through to postoperative wound management. However, there is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation.
Sections du résumé
Background
UNASSIGNED
The occurrence of surgical site infections (SSIs) is associated with increased risk of mortality, development of other infections, and the need for reintervention, posing a significant health burden. The aim of this review was to examine the current data and guidelines around the use of antiseptic povidone‑iodine (PVP-I) for the prevention of SSIs at each stage of surgical intervention.
Methods
UNASSIGNED
A literature search for selected key words was performed using PubMed. Additional papers were identified based on author expertise.
Results
UNASSIGNED
Scientific evidence demonstrates that PVP-I can be used at every stage of surgical intervention: preoperative, intraoperative, and postoperative. PVP-I is one of the most widely used antiseptics on healthy skin and mucous membranes for preoperative surgical site preparation and is associated with a low SSI rate. For intraoperative irrigation, aqueous PVP-I is the recommended agent and has been demonstrated to decrease SSIs in a range of surgical settings, and for postoperative wound healing, there is a growing body of evidence to support the use of PVP-I.
Conclusions
UNASSIGNED
There is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation. The use of a single agent (PVP-I) at each stage of surgical intervention could potentially provide advantages, including economic benefits, over agents that can only be used at discrete stages of the surgical procedure.
Key message
UNASSIGNED
Evidence supports the use of PVP-I at all stages of surgical intervention, from preoperative measures (including skin preparation, preoperative washing, and nasal decolonization) to intraoperative irrigation, through to postoperative wound management. However, there is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation.
Identifiants
pubmed: 37034245
doi: 10.1016/j.sopen.2023.03.005
pii: S2589-8450(23)00011-8
pmc: PMC10074992
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
9-17Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
SM declares that he has nothing to disclose. DL has served as a consultant for Viatris. KG declares that he has nothing to disclose. PL has served as a consultant for Viatris. PRO declares that he has nothing to disclose.
Références
Crit Care Med. 2004 Mar;32(3):708-13
pubmed: 15090951
Clin Neurol Neurosurg. 2014 Mar;118:49-52
pubmed: 24529229
Int J Antimicrob Agents. 2020 Sep;56(3):106064
pubmed: 32599228
Infect Control Hosp Epidemiol. 2010 Dec;31(12):1219-29
pubmed: 20969449
Int J Surg. 2017 Aug;44:260-268
pubmed: 28648795
Clin Microbiol Infect. 2020 May;26(5):563-571
pubmed: 31586658
J Hosp Infect. 2010 Nov;76(3):191-9
pubmed: 20619933
Surg Gynecol Obstet. 1979 Mar;148(3):409-11
pubmed: 369009
J Hosp Infect. 2014 Jan;86(1):24-33
pubmed: 24268456
Rev Urol. 2009 Fall;11(4):190-5
pubmed: 20111631
Infect Control Hosp Epidemiol. 2003 Mar;24(3):225-7
pubmed: 12683517
Aesthet Surg J. 2013 Jul;33(5):675-80
pubmed: 23757043
J Antimicrob Chemother. 2015 Oct;70(10):2681-92
pubmed: 26142407
J Bone Jt Infect. 2017 Jan 1;2(1):15-22
pubmed: 28529860
Int Wound J. 2004 Dec;1(4):247-73
pubmed: 16722874
Arthroplast Today. 2017 May 12;3(4):294-297
pubmed: 29204500
Antimicrob Agents Chemother. 2008 Oct;52(10):3633-6
pubmed: 18676882
Br J Surg. 2011 Mar;98(3):461-2; author reply 462
pubmed: 21254033
BMC Infect Dis. 2017 Feb 13;17(1):143
pubmed: 28193164
J Clin Microbiol. 2013 Feb;51(2):417-21
pubmed: 23175247
Spine (Phila Pa 1976). 2005 Aug 1;30(15):1689-93
pubmed: 16094267
Cureus. 2020 Apr 24;12(4):e7813
pubmed: 32467789
Virol J. 2009 Aug 13;6:124
pubmed: 19678928
Orthop Traumatol Surg Res. 2018 Feb;104(1S):S19-S24
pubmed: 29203432
J Orthop Res. 2005 Jan;23(1):127-33
pubmed: 15607884
J Hosp Infect. 2017 Jul;96(3):221-222
pubmed: 28526172
Int J Antimicrob Agents. 2016 Jul;48(1):86-90
pubmed: 27230473
J Hosp Infect. 2007 Sep;67(1):67-71
pubmed: 17664016
Int Wound J. 2017 Apr;14(2):316-321
pubmed: 27094360
J Hosp Infect. 2022 May;123:67-73
pubmed: 35271958
Aesthet Surg J. 2013 May;33(4):615-7
pubmed: 23636633
Am J Infect Control. 2020 Apr;48(4):456-459
pubmed: 31735591
J Clin Microbiol. 2020 Jan 28;58(2):
pubmed: 31645372
Lancet Infect Dis. 2021 Jul;21(7):1038-1048
pubmed: 33539734
Int Wound J. 2009 Dec;6(6):420-30
pubmed: 20051094
J Wound Ostomy Continence Nurs. 1994 Nov;21(6):224-31
pubmed: 7704129
Lancet. 2015 Nov 21;386(10008):2069-2077
pubmed: 26388532
Lancet Infect Dis. 2016 Dec;16(12):e276-e287
pubmed: 27816413
Postgrad Med J. 1993;69 Suppl 3:S78-83
pubmed: 8290463
APMIS. 2014 Oct;122(10):961-7
pubmed: 24628476
Clin Microbiol Rev. 2017 Jul;30(3):827-860
pubmed: 28592405
J Wound Care. 2009 Aug;18(8):343-6
pubmed: 19862874
Eur J Clin Microbiol Infect Dis. 2010 Apr;29(4):373-82
pubmed: 20108109
JAMA Surg. 2017 Aug 01;152(8):784-791
pubmed: 28467526
Postgrad Med J. 1993;69 Suppl 3:S66-9
pubmed: 8290461
Adv Exp Med Biol. 2015;830:47-67
pubmed: 25366220
J Arthroplasty. 2016 Jan;31(1):215-8
pubmed: 26521129
Cochrane Database Syst Rev. 2016 Mar 29;3:CD011712
pubmed: 27021482
Antimicrob Agents Chemother. 2017 Dec 21;62(1):
pubmed: 29061748
J Invest Dermatol. 2006 Dec;126(12):2731-3
pubmed: 16826165
J Orthop Res. 2010 Sep;28(9):1252-6
pubmed: 20187117
Infect Control Hosp Epidemiol. 2014 Jul;35(7):826-32
pubmed: 24915210
J Long Term Eff Med Implants. 2016;26(3):237-243
pubmed: 28134606
JAMA Surg. 2015 May;150(5):390-5
pubmed: 25738898
Infect Control Hosp Epidemiol. 1999 Apr;20(4):250-78; quiz 279-80
pubmed: 10219875
Infect Control Hosp Epidemiol. 1992 Oct;13(10):606-8
pubmed: 1334988
J Intern Med. 2012 Dec;272(6):541-61
pubmed: 23025745
J Antimicrob Chemother. 2010 Aug;65(8):1712-9
pubmed: 20551215
Crit Rev Microbiol. 2016;42(2):293-309
pubmed: 25159044
Crit Care Nurs Q. 2009 Apr-Jun;32(2):94-8
pubmed: 19300072
J Plast Reconstr Aesthet Surg. 2020 Feb;73(2):391-407
pubmed: 31582320
J Med Microbiol. 2017 Dec;66(12):1744-1751
pubmed: 29134935
Clin Microbiol Infect. 2019 Oct;25(10):1239-1245
pubmed: 31238121
Eur J Dermatol. 2014 Jan-Feb;24(1):3-9
pubmed: 24492204
J Clin Microbiol. 1982 Apr;15(4):635-9
pubmed: 7040461
Toxicol Lett. 2015 Jun 15;235(3):155-60
pubmed: 25858112
Biofouling. 2018 May;34(5):507-518
pubmed: 29873244
Br J Surg. 2010 Nov;97(11):1614-20
pubmed: 20878942
Int J Antimicrob Agents. 2018 Nov;52(5):673-677
pubmed: 29775686
J Antimicrob Chemother. 2008 Jun;61(6):1281-7
pubmed: 18364400
Infect Control Hosp Epidemiol. 2014 Jun;35(6):605-27
pubmed: 24799638
Clin Orthop Relat Res. 2018 Mar;476(3):648-653
pubmed: 29443852
J Arthroplasty. 2013 Jun;28(6):918-21
pubmed: 23528554
Burns. 2005 Jun;31(4):489-94
pubmed: 15896513
J Matern Fetal Neonatal Med. 2018 Mar;31(5):670-676
pubmed: 28274149
Lancet Infect Dis. 2017 Oct;17(10):1024-1025
pubmed: 28948926
J Arthroplasty. 2020 Aug;35(8):2267-2273
pubmed: 32229147
J Bone Joint Surg Br. 1998 May;80(3):437-40
pubmed: 9619932
Int Orthop. 2011 Nov;35(11):1719-23
pubmed: 21240607
J Antimicrob Chemother. 2005 Mar;55(3):283-8
pubmed: 15705644
Dermatol Ther. 2021 Jan;34(1):e14416
pubmed: 33068030
Int Wound J. 2007 Jun;4(2):124-37
pubmed: 17651228
Acta Orthop. 2009 Aug;80(4):486-90
pubmed: 19593719
Australas J Dermatol. 2020 Aug;61(3):217-225
pubmed: 32201935
Ann R Coll Surg Engl. 2016 May;98(5):320-3
pubmed: 27087324
Spine Deform. 2020 Feb;8(1):45-50
pubmed: 31981142
Antimicrob Resist Infect Control. 2021 Jan 22;10(1):17
pubmed: 33482910
Sci Rep. 2017 Apr 20;7(1):991
pubmed: 28428640
Microorganisms. 2017 Apr 12;5(2):
pubmed: 28417918
Int Orthop. 2009 Jun;33(3):829-33
pubmed: 18327582
J Antimicrob Chemother. 2010 Jun;65(6):1195-206
pubmed: 20378671
Int Wound J. 2017 Feb;14(1):172-179
pubmed: 26968574
J Bone Joint Surg Am. 2014 Feb 19;96(4):e34
pubmed: 24553903
Dermatol Surg. 2017 Jan;43(1):1-6
pubmed: 27399954
J Antimicrob Chemother. 2018 Feb 1;73(2):494-502
pubmed: 29165561
Br J Ophthalmol. 2003 Feb;87(2):163-7
pubmed: 12543744
Infect Control Hosp Epidemiol. 2016 May;37(5):590-7
pubmed: 26828094
J Arthroplasty. 2012 Jan;27(1):27-30
pubmed: 21550765
Antimicrob Agents Chemother. 2020 Aug 20;64(9):
pubmed: 32571829
Am J Surg. 1986 Mar;151(3):400-6
pubmed: 3513654
Lancet Infect Dis. 2017 Oct;17(10):1023-1024
pubmed: 28948925
J Arthroplasty. 2022 Feb;37(2):226-231.e1
pubmed: 34742876
Dermatology. 2002;204 Suppl 1:70-4
pubmed: 12011525
Br J Anaesth. 2019 Jul;123(1):e95-e103
pubmed: 30955832
Braz J Med Biol Res. 2017 Dec 18;51(2):e6736
pubmed: 29267501
J Orthop Res. 2014 Jan;32 Suppl 1:S26-30
pubmed: 24464895
Biomed Res Int. 2013;2013:804391
pubmed: 24308006
Clin Infect Dis. 2003 Dec 1;37(11):1453-60
pubmed: 14614667
J Hosp Infect. 2003 Oct;55(2):108-15
pubmed: 14529634
J Bone Joint Surg Br. 2000 May;82(4):620
pubmed: 10855896
J Bone Joint Surg Br. 1999 Nov;81(6):995-6
pubmed: 10615973
Eur Spine J. 2006 Jun;15(6):1005-14
pubmed: 16133077
Clin Microbiol Rev. 1999 Jan;12(1):147-79
pubmed: 9880479
World Allergy Organ J. 2020 Oct 30;13(10):100472
pubmed: 33204386
Antimicrob Agents Chemother. 2017 Dec 21;62(1):
pubmed: 29038276
Lancet Infect Dis. 2018 May;18(5):516-525
pubmed: 29452941
Int Wound J. 2021 Jun;18(3):342-358
pubmed: 33314723
PLoS One. 2012;7(5):e36659
pubmed: 22606280
Plast Reconstr Surg. 2004 Sep 1;114(3):706-10; discussion 711-2
pubmed: 15318049
Aesthet Surg J. 2018 May 15;38(6):623-626
pubmed: 29452341
J Hosp Infect. 1992 Aug;21(4):291-9
pubmed: 1355784