Systemic iodine levels increase with povidone-iodine irrigation, but does this affect thyroid functions? A case-control study.
Humans
Povidone-Iodine
/ administration & dosage
Case-Control Studies
Male
Female
Iodine
/ urine
Aged
Middle Aged
Anti-Infective Agents, Local
/ administration & dosage
Therapeutic Irrigation
/ methods
Arthroplasty, Replacement, Hip
/ adverse effects
Thyroid Gland
/ surgery
Arthroplasty, Replacement, Knee
/ adverse effects
Thyroid Function Tests
Aged, 80 and over
Periprosthetic joint infection
Povidone iodine
Thyroid functions
Urine iodine
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
08 Oct 2024
08 Oct 2024
Historique:
received:
26
04
2024
accepted:
25
06
2024
medline:
9
10
2024
pubmed:
9
10
2024
entrez:
8
10
2024
Statut:
epublish
Résumé
Intraoperative irrigation with diluted povidone iodine (PI) can be used to reduce the incidence of infection-related complications in arthroplasty surgeries. Since PI is associated with many interventions, especially skin antisepsis, its systemic effects are being studied. The aim of our study is to evaluate the systemic effects of PI, which we use as an irrigation solution, by means of urine iodine and thyroid function tests. In this case-control study, 96 patients who underwent knee or hip arthroplasty were included and divided into two groups according to the irrigation solution. In the first group, PI was added to the standard irrigation. The second group was considered as the control group and only standard irrigation was applied. Urine iodine, thyroid stimulating hormone, free T3 and free T4 values were compared in the preoperative and postoperative periods of these two groups. In this way, the effect of absorbed iodine on thyroid functions was investigated. In the diluted PI group, urinary iodine levels were measured at maximum levels (450 µg/L) in the early postoperative period in most of the patients. The statistically significant difference in urinary iodine levels between the PI group and the control group, which started in the early postoperative period, continued until the last follow-up on the 14th postoperative day. In terms of thyroid functions, the observed differences were not statistically significant. Studies to reduce periprosthetic infection show that PI can be preferred for irrigation before the closure of the joint area in total joint arthroplasty. Although the success of this treatment in periprosthetic infection has been investigated, its systemic examination has not been demonstrated. It was determined that PI treatment, which was seen to decrease in the systemic circulation within 14 days, did not show a statistically significant change in terms of thyroid functions when used at the determined concentration and duration. These results should be evaluated with larger and longer-term studies. Clinical trials ID no. NCT05599841.
Sections du résumé
BACKGROUND
BACKGROUND
Intraoperative irrigation with diluted povidone iodine (PI) can be used to reduce the incidence of infection-related complications in arthroplasty surgeries. Since PI is associated with many interventions, especially skin antisepsis, its systemic effects are being studied. The aim of our study is to evaluate the systemic effects of PI, which we use as an irrigation solution, by means of urine iodine and thyroid function tests.
METHODS
METHODS
In this case-control study, 96 patients who underwent knee or hip arthroplasty were included and divided into two groups according to the irrigation solution. In the first group, PI was added to the standard irrigation. The second group was considered as the control group and only standard irrigation was applied. Urine iodine, thyroid stimulating hormone, free T3 and free T4 values were compared in the preoperative and postoperative periods of these two groups. In this way, the effect of absorbed iodine on thyroid functions was investigated.
RESULTS
RESULTS
In the diluted PI group, urinary iodine levels were measured at maximum levels (450 µg/L) in the early postoperative period in most of the patients. The statistically significant difference in urinary iodine levels between the PI group and the control group, which started in the early postoperative period, continued until the last follow-up on the 14th postoperative day. In terms of thyroid functions, the observed differences were not statistically significant.
CONCLUSION
CONCLUSIONS
Studies to reduce periprosthetic infection show that PI can be preferred for irrigation before the closure of the joint area in total joint arthroplasty. Although the success of this treatment in periprosthetic infection has been investigated, its systemic examination has not been demonstrated. It was determined that PI treatment, which was seen to decrease in the systemic circulation within 14 days, did not show a statistically significant change in terms of thyroid functions when used at the determined concentration and duration. These results should be evaluated with larger and longer-term studies.
TRIAL REGISTRATION
BACKGROUND
Clinical trials ID no. NCT05599841.
Identifiants
pubmed: 39380015
doi: 10.1186/s13018-024-04877-8
pii: 10.1186/s13018-024-04877-8
doi:
Substances chimiques
Povidone-Iodine
85H0HZU99M
Iodine
9679TC07X4
Anti-Infective Agents, Local
0
Banques de données
ClinicalTrials.gov
['NCT05599841']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
636Informations de copyright
© 2024. The Author(s).
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