The efficacy and safety of povidone-iodine as a pleurodesis-inducing agent in spontaneous pneumothorax: An experience from a tertiary care hospital for publication

Abstract

Background: Primary or secondary spontaneous pneumothorax (PSP or SSP) is a common treatable disease but notorious for its recurrence over the years. Intercoastal tube (ICT) thoracostomy is often done to relieve pneumothorax. Simultaneous pleurodesis could be done by pushing pleurodesing chemical agent through ICT. Pleurodesis would obliterate the pleural space and prevent its recurrence. Povidone-iodine (10%) was a cheaper pleurodezing agent with efficacy rate of 60%–80% with minimal complication as per many studies. Aims: Our aims were to study the efficacy, that is, success rate as well as safety of povidone-iodine for pleurodesis in the treatment of PSP or SSP by tube thoracostomy and also to study the demographic characteristic. Setting and Design: A prospective observational study was conducted over 30 patients of PSP and SSP in a rural tertiary care hospital. Materials and Methods: As per inclusion and exclusion criteria, consecutively attending patients (male: female 26:4) were admitted. Clinicoradiologically, the diagnosis of PSP or SSP was made. Patients were treated by ICT thoracostomy under LA to relive pneumothorax. After lung expansion, pleurodesis was done by pushing the povidone-iodine solution (80 ml) through same thoracostomy tube. Follow-up (FU) was done up to 180 days. The outcome was analyzed statistically. Statistical Analysis: Descriptive statistics were used using Microsoft Excel 2007. Results: The “efficacy or success rate” of povidone iodine-induced pleurodesis was 90% (27/30) up to 3rd FU. However, the success rate of pleurodesis was 80% (24/30) till 180 days (4th FU). The procedure showed minimal complication. Chest pain occurred in majority 76% (23/30) of patients after pleurodesis. Spirometry, visual disturbance, and thyroid dysfunction were unaffected. Conclusion: Povidone-iodine (10%) came out as efficacious, safe, sclerosing agent for pleurodesis in PSP or SSP treatment by tube thoracostomy with a good success rate and minimal complication.