Povidone-iodine Research Articles

The effectiveness of aloe vera gel compared to povidone iodine on wound healing

Wound is damage that occurs in a tissue. The tissue most frequently injured is the skin. Treatment of wounds is carried out in various ways, however, as first aid, drugs containing povidone iodine are usually given. Apart from povidone iodine, we can use aloe vera as a wound treatment. According to various sources of literature obtained, many of the ingredients in aloe vera are considered superior for wound healing such as accelerating epithelization and healing time, as well as minimizing side effects. Comparison of the effectiveness of aloe vera and povidone iodine in terms of consistency, healing time, basic ingredients, and side effects. Based on these aspects, it can be concluded that aloe vera is more effective in wound healing compared to povidone iodine.

P-315. Safety and Effectiveness of Nasal Povidone-Iodine Decolonization Among Patients on Hemodialysis: A Multicenter Stepped-Wedge Cluster Randomized Trial

Abstract Background The SHEA/IDSA/APIC Strategies to Prevent MRSA Transmission and Infection Practice Recommendations advised that facilities consider decolonizing patients on hemodialysis. We implemented a nasal decolonization intervention in which patients self-administered povidone-iodine (PVI) at each dialysis session. We aimed to assess intervention safety and effectiveness. Methods We performed a stepped wedge cluster randomized trial at 16 outpatient hemodialysis units affiliated with 5 academic medical centers between 2020-2023. Adverse events were self-reported at 1 and 6 months. While the analysis was at the hemodialysis unit level, patients were required to give verbal informed consent for PVI use. Outcomes included National Healthcare Safety Network reportable dialysis events aggregated at hemodialysis unit level, including bloodstream infections (BSI), access-related BSI, and central venous catheter (CVC) BSI for all pathogens and for Staphylococcus aureus (SA). The primary outcome was SA BSI. A generalized linear mixed model with a negative binomial distribution, log link function, and an offset for person-months with a random intercept for each hemodialysis unit was performed. Results Overall, 1,351 patients received hemodialysis at these centers each month. Of those, 362 patients verbally consented to use PVI. Among these, 3.9% reported side effects: nasal drip, congestion or burning/stinging, unpleasant smell, headache, or minor nose bleed. A reported side effect ‘yellow tears’ was assessed via chart review and resolved by discontinuing PVI. There were no statistically significant associations between unit level randomization to the PVI intervention and infections. However, there was a non-statistically significant trend toward a protective association between unit-level randomization to PVI and SA infections, particularly SA CVC BSI.(Table) Conclusion Long-term nasal decolonization with PVI was safe with few adverse events. Unit level randomization to the PVI intervention did not significantly decrease unit-level infections. Given low patient enrollment and added infection prevention interventions due to COVID-19, the study could not determine if PVI decolonization could decrease BSI rates in the hemodialysis setting. Disclosures Marin Schweizer, PhD, 3M: Grant/Research Support Anitha Vijayan, MD, Baxter: Honoraria|NxStage: Advisor/Consultant|Qanta: Honoraria David A. Pegues, MD, DaVita/Total Renal Care: Advisor/Consultant Daniel Diekema, MD, Affinity Biosensors: Grant/Research Support|bioMerieux, Inc: Grant/Research Support Loreen Herwaldt, MD, 3M: Grant/Research Support|PDI: Grant/Research Support

Innovative Antibiotic Therapies for Carbapenem-Resistant Gram-Negative Bacterial Infections: Clinical Efficacy, Safety, and Comparative Studies

This review provides an overview of recent research and advancements in infection prevention and the treatment of drug-resistant bacterial diseases. Cefiderocol, a novel siderophore cephalosporin, has demonstrated effectiveness against carbapenem-resistant bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii. Clinical trials, including APEKS-NP and CREDIBLE-CR, affirm its efficacy for hospital-acquired pneumonia (HAP) but highlight concerns over increased mortality due to severe renal complications. Cefiderocol has shown superior outcomes in complicated urinary tract infections (cUTI) compared to imipenem–cilastatin. A comparison of colistin monotherapy versus combination therapy with meropenem for carbapenem-resistant infections revealed no significant improvement in clinical outcomes with combination therapy but noted delays in resistance development. Colistin–rifampicin combination therapy showed potential benefits for colistin-resistant Acinetobacter baumannii, although results were not statistically significant. SPR206, a polymyxin derivative, and durlobactam, a β-lactamase inhibitor, show promise in addressing these resistant strains, with durlobactam demonstrating efficacy in combination with sulbactam and imipenem–cilastatin. Additional studies investigated antibiotic strategies for resistant infections, including cefoperazone–sulbactam versus combination therapy with tigecycline, and examined infection-prevention strategies in surgical settings, comparing chlorhexidine–alcohol and povidone–iodine. This research highlights the importance of optimizing treatment regimens and infection-control measures across various healthcare settings, including neonatology and surgical care.

P-303. Mupirocin Resistance is Common in Tampa, Florida Staphylococcus aureus Clinical Isolates

Abstract Background Mupirocin (Mup) is a topical drug used to decolonize carriers of Staphylococcus aureus (SA) to prevent later SA infection. A spot survey of SA isolates at Tampa General Hospital (TGH) revealed a prevalence in Mup resistance of ∼40%, leading to a change of decolonization protocol from mupirocin to povidone iodine in January 2020, just prior to the COVID pandemic. We determined the prevalence of Mup resistance in a random sampling of clinical isolates before and after change in decolonization protocol. Methods A total of 211 PreCOVID (before 2020) and 173 PostCOVID (after 2021) samples from various sources (blood, bone, eye, fluid, respiratory, urine, and wound) were tested with minimum inhibitory concentration for Mup resistance using literature values for susceptible, low resistance, and high resistance. Oxacillin sensitivity, to verify MRSA isolates, was tested in parallel. Results were analyzed via χ² for significance (p=0.05). Results Comparison of Mup resistance levels between the Pre- and PostCOVID time points showed no significant difference (p=0.460). PreCOVID: 71.1% susceptible, 8.1% low resistance, 20.9% high resistance. PostCOVID: 74.0% susceptible, 9.8% low resistance, and 16.2% high resistance. MRSA status correlated with Mup resistance in both Pre- (p< 0.001) and PostCOVID samples (p=0.001). Blood vs Non-Blood samples differed in Mup resistance in the PreCOVID period (20.7% blood vs 34.1% non-blood, p=0.037), whereas samples in the PostCOVID period showed no significant difference in Mup resistance (22.8% blood vs 28.7% non-blood, p=0.375). Notably, 46.2% PreCOVID Respiratory were resistant to Mup (p=0.016). 26.3% PostCOVID Respiratory were resistant to Mup (p=0.651). Conclusion Change in decolonization protocol did not influence the overall prevalence of Mup resistance. Respiratory samples made up a significant proportion of the resistant samples in the PreCOVID time point, suggesting differences in prevalence of Mup resistance in different clinical sites. Further molecular epidemiological studies are needed to determine if specific sites of infection or specific patient groups are more likely to be colonized with Mup resistant SA isolates. Disclosures All Authors: No reported disclosures

Povidone-Iodine Versus Saline Irrigation on Reduction of Surgical Site Infections in Total Hip and Knee Arthroplasty: A Retrospective, Propensity-Matched Cohort.

Introduction: Surgical site infection (SSI) after total hip and knee arthroplasty (THA/TKA) is a major complication leading to morbidity and mortality. Perioperative irrigation, frequently with antiseptic compounds including povidone-iodine (PI), is the standard of care in reducing SSI. Evidence supporting the value of PI versus nonantiseptic substances varies. This study aims to identify whether PI irrigation in THA/TKA reduces the rate of SSI versus normal saline irrigation. Patients and Methods: A retrospective, propensity-matched cohort study of patients who underwent TKA or THA was conducted using data from patient charts, hospital infection control surveillance software, and operative reports. SSI rates of patients who had received PI versus saline irrigation were compared. Patient medical status, demographics, and procedure details were considered for propensity score determination and matching. Results: The study encompassed 21,482 patients. The unadjusted univariate analysis demonstrated no statistically significant difference in SSI rate between PI and saline (p = 0.759). Multivariate analysis showed that men, patients with diabetes, and those with a 2-3 h procedure time had increased risk of SSI, but differences were not observed between irrigation groups. Propensity score matching yielded 21 (0.25%) SSI in the matched PI group and 19 (0.23%) in the saline group (odds ratio: 1.10; confidence interval: 0.59-2.06). Conclusions: This investigation proposes that PI irrigation is not significantly different to saline in reducing SSI in this population. When cost is of concern, saline irrigation is equally effective and therefore a sensible option.

Chlorhexidine Compared with Povidone-Iodine in Intravitreal Injection: A Systematic Review and Meta-Analysis.

Introduction: Povidone-iodine (PI) is the standard antiseptic for intravitreal injections (IVIs), while chlorhexidine (CHX) is a potential alternative. The efficacy of PI versus CHX in preventing endophthalmitis remains debated, with studies showing mixed results. Objective: To compare the effectiveness of using PI compared with CHX in IVI procedures regarding endophthalmitis rates, culture-positive endophthalmitis rates, and changes in visual acuity. Methods: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We searched the PubMed, EMBASE, Cochrane, and Web of Science databases for studies using PI compared with CHX in the IVI procedure. Statistical analysis was done using R software. Results: Four studies encompassing 453,340 eyes were included. The pooled results showed no statistical differences in endophthalmitis rates [odds ratio (OR): 1.26; 95% confidence interval (CI): 0.53-3.00]. In those who received the CHX group, there was no decrease in the rates of culture-positive endophthalmitis (OR: 2.04; 95% CI: 0.76-5.47), and the pooled results revealed no statistical differences in the mean change in visual acuity between the CHX and PI groups at final follow-up [mean difference: -0.02; 95% CI: -0.40 to 0.36]. Significant heterogeneity was identified in the post-procedure endophthalmitis rate and culture-positive endophthalmitis rate. Conclusions: Despite finding a trend toward higher rates of endophthalmitis with CHX, there are no statistical differences in using PI compared with CHX. However, our results are limited due to high heterogeneity. PI remains the gold standard, and a widespread shift to CHX cannot be justified based on the findings of this analysis.

Topical sevoflurane role as antiseptic on normal conjunctival flora in a rabbit model

Aims/Purpose: To assess the antiseptic properties of Sevoflurane (SF) when topically applied to the ocular surface in an animal model, and to compare the results with that of 5% Povidone Iodine (PY), a commonly used ophthalmic antiseptic.Methods: This randomized clinical trial involved 24 eyes from 12 New Zealand white rabbits, which were divided into two groups: SF (n = 12) and PY (n = 12), based on the substance administered. Prior to the application of any agent, baseline samples were collected from the conjunctival sac of each eye to determine the normal conjunctival flora. Subsequently, a single dose of 0.1 mL of either SF or PY was administered according to the group allocation. Conjunctival sac samples were then taken at 5 and 30 minutes post‐application. The collected samples were subjected to microbiological analysis.Results: At the commencement of the study, Moraxella cuniculi was identified as the predominant species, with a statistically significant higher colony‐forming units per milliliter (CFU/mL) compared to other species (p < 0.001). In the SF group, there was a statistically significant reduction in CFU/mL for both Moraxella cuniculi and Staphylococcus aureus following treatment. Conversely, in the PY group, a significant reduction was observed only for Moraxella cuniculi. Comparative analysis between the SF and PY groups revealed no statistically significant differences in the reduction of CFU/mL for Moraxella cuniculi at any time point during the study (p > 0.05).Conclusions: Topical application of SF effectively reduces the CFU/mL of predominant germs on the ocular surface of albino rabbits, yielding results comparable to those achieved with PY.

An unusual presentation of rhinosporidiosis in the lacrimal sac – A case report and a literature review

ABSTRACT Rhinosporidiosis is a rare granulomatous disease affecting the nasal mucosa, nasopharynx, skin and eyes due to Rhinosporidium seeberi. Lacrimal Sac involvement is very rare. Hence, we report an unusal presentation of rhinosporidiosis in lacrimal sac area in an adult male patient who presented with painless boggy swelling in lacrimal sac area with positive history of bath in pond and diagnosis was confirmed with histopathological examination. To prevent the recurrence, the patient was treated with 5% Povidone Iodine intra operatively and use of oral Dapsone (100 mg/day) for three months post-operatively.

Application of povidone Iodine for open appendectomy wound as a preventive measure for postoperative wound infection

Application of povidone Iodine for open appendectomy wound as a preventive measure for postoperative wound infection

Retrospective review of the annual endophthalmitis rates following intravitreal injections at Royal Bournemouth Hospital over an eight‐year period from 01/02/2016 until 31/01/2024

Aims/Purpose: To present the annual rates of post‐intravitreal injection endophthalmitis at Royal Bournemouth Hospital (RBH) over an eight‐year period from 01/02/2016 until 31/01/2024.Methods: The total number of intravitreal injections performed was identified retrospectively from our electronic records. The cases of post‐injection endophthalmitis were identified from the department's written logbook record.Results: Over the above 8‐year‐period, a total number of 13 cases of endophthalmitis were identified. The total number of injections performed over this 8‐year‐period was 54,134. The annual endophthalmitis rates fluctuated from a minimum 0% (year 01/02/2016 until 31/01/20217) to a maximum of 0.05% (year 01/02/2019 until 31/01/2020). Mean annual endophthalmitis rate over this 8‐year‐period was 0.025%. 1 case occurred after an intravitreal Ozurdex injection and 12 following anti‐VEGF injections.Conclusions: Despite the increasing number of injections every year, we noted that our endophthalmitis rates were consistently much lower than the estimated rate of 1 in 1000 (0.1%) in the literature. We postulate that our current standard local protocols and practices which include the use of sterile gloves, sterile drapes, face masks and pre‐injection instillation of povidone iodine in the fornix have played a pivotal role in keeping the annual endophthalmitis rates very low. Furthermore, the introduction of novel agents of biosimilars to Ranibizumab (Ongavia) and Faricimab (Vabysmo) which are withdrawn from vials and are not available in pre‐filled syringes did not have any adverse impact on our endophthalmitis rates. In 2014, the administration of chloramphenicol 0.5% antibiotic eye drops post‐intravitreal injections were stopped permanently. In 2016, specialist nurse injectors were introduced in our clinical practice. Based on our endophthalmitis rates over this 8‐year‐period, these two important changes in the clinical practice do not seem to have had a negative impact in our annual endophthalmitis rates. Our aim is to continue auditing our rates annually in order to ensure that we are a safe to practice macular unit and to maintain high quality patient care.

Clinical management of ulcerative thelitis in buffaloes (5 Cases)

Ulcerative thelitis is the inflammation of the teat and ulceration of the outer skin of the teats, there will be acute inflammation at early stage of the disease subsequently there will be thickening, narrowing and closure of the teat canal, causing improper drainage of milk from the affected teat. In later stages there will be sloughing of the skin over the teats and falling of the entire teat itself leading loss of milk production. In the present study the wounds were cleaned with povidone iodine animals were treated with a broad-spectrum antibiotic (enrofloxacin), Antioxidant injection (vit-E and selenium), antihistamine injection (Zeet) and spray Budocort 200 mcg were used. Three buffaloes showed the signs of improvement after 5 days of treatment.

A Comparison Between The Administration of Povidone Iodine 10% and Aloe Vera Gel on The Healing of Wistar Rat Burns (Rattus Norvegicus)

Aloe vera has long been known for its diverse properties, including wound healing. Compounds such as saponins, tannins, and polyphenols contained in aloe vera provide anti-inflammatory, antibacterial, and accelerate tissue regeneration. This study aims to compare the effectiveness between Povidone Iodine 10% and Aloe Vera Gel on burn wound healing in Wistar Rats (Rattus norvegicus). The study used an experimental design with post-test only control group design. A total of 33 rats were divided into three groups: control group without treatment, Povidone Iodine 10% group, and Aloe Vera Gel group. Observations were made on days 0, 7, and 14 with parameters of wound diameter, percentage of wound reduction, and histopathological analysis to assess the amount of blood vessel formation, fibroblasts, macrophages, and epidermal thickness. The results showed that the administration of Aloe Vera Gel is effective in healing burn wounds, especially in the inflammatory and proliferation phases.

Does a Specific Sequential Combination of Antiseptic Solutions for Chemical Debridement in Periprosthetic Joint Infection Improve Outcomes vs. Solution Alone? An In Vivo Study.

Background: Chemical debridement is a fundamental step during the surgical treatment of both acute and chronic periprosthetic joint infection (PJI). However, there is no consensus on the optimal solution, nor is there sufficient evidence on the optimal irrigation time and combination of solutions. In an in vitro study, our group recently demonstrated that sequential combination debridement (SCD) with 3% acetic acid (AA) followed by 10% povidone iodine (PI) and 5 mM hydrogen peroxide (H2O2) was the best strategy for reducing bacterial load. The present study aimed to validate these findings in an in vivo model. Results: The median (IQR) log CFU/mL was lower in the group of mice treated with SCD (2.85 [0.00-3.72]) than in the Bactisure™ group (4.02 [3.41-4.72], p = 0.02). While this reduction was also greater than in the PI group (3.99 [1.11-4.33]), the difference did not reach statistical significance (p = 0.19). Cell viability assays showed no differences between treatments. S. aureus bacteremia was detected in 10% of mice treated with SCD, compared to 30% in the PI group and 10% in the Bactisure™ group. The difference was not statistically significant (p = 0.36). Conclusion: Our findings confirm that SCD significantly reduced bacterial load in an in vivo S. aureus PJI model, showing superior anti-biofilm activity compared to Bactisure™ and comparable performance to PI alone. These results highlight SCD's potential to serve as a standardized chemical debridement protocol, combining enhanced efficacy with clinical applicability. Methods: We tested SCD with 3% AA for 3 min, 10% PI for 3 min, and H2O2 for 3 min in a 7-day Staphylococcus aureus (ATCC29213)-based murine femur PJI model and compared the results with single treatments of 10% PI for 3 min or Bactisure™ solution for 3 min. A sterile steel implant with local administration of saline solution for 3 min was used as a non-infected control. After completing irrigation procedures, under anesthesia, mice were euthanized, and implants were analyzed for CFU/mL counts and cell viability rates. Blood cultures were obtained pre-euthanasia to detect bacteremia.

Effectiveness of Gedong Gincu Mango Leaf Extract Gel (Mangifera indica L. var. Gedong gincu) on Cut Wound Healing in Male White Rats (Rattus norvegicus) of the Wistar Strain

Background: The Indonesia Basic Health Research data show the prevalence of wounds including incision/scratches/stab wounds reaches 20.1%. Natural herbal products play an important role in the wound healing process functioning as anti-inflammatories, antioxidants, antimicrobials, and collagen formation. Mango leaves are often considered waste even though they have many health benefits with the high content of coactive compounds, such as alkaloids, flavonoids, tannins, and saponins which are good for cut wound healing. The use of gel is more stable and controlled release compared to other topical preparations. Gedong Gincu mangoes originating from West Java have unique properties and they are marketed widely in some areas including Cirebon. Aims: This study aims to identify the most effective concentration of Gedong Gincu mango leaf extract on cut wound healing in male white rats (Rattus norvegicus) of the Wistar Strain. Methods: This study used a post-test-only control group design. The extract gel used three levels of concentration, namely 40%, 50%, and 60%. The positive control used 10% povidone iodine while the negative control used a gel base. The gel was applied to the cut wound twice a day for 14 days. Results: The average length of the cut wound was 0.916 cm, 0.912 cm, and 1.050 cm for concentration levels of 40%, 50%, and 60%. For the positive and negative controls, it reached 0.996 cm and 0.702 cm respectively. This indicates no significant difference in the length of the cut wound with a p-value of 0.121 (p>0.05). The wound healing process was effective at a concentration level of 60% as indicated by the disappearance of erythema and edema. Conclusion: Mango leaf extract gel (Mangifera indica L.var. Gedong Gincu) is effective in healing cut wounds with the disappearance of erythema and edema in male white rats (Rattus norvegicus) Wistar strain with a concentration of 60%. Received: 25 September 2024 | Reviewed: 19 October 2024 | Revised: 30 November 2024 | Accepted: 15 December 2024.

Honey As A Treatment For Diabetic Foot Ulcer: A Systematic Review

Background : Increased number of antibiotic-resistance bacteria has made honey widely reused as a modern wound treatment, including for Diabetic Foot Ulcer (DFU) treatment. Researchers have studied mean duration of wound healing and effectivity of honey dressing compared to other substances, such as povidone iodine, normal saline or alginate. This systematic review was conducted to objectively evaluate mean duration of wound healing using topical honey dressing compared to other substances in the treatment of DFU. Method : All RCT and CCT trials were collected from 4 electronic databases using keywords “Honey”, “Honey dressing”, “Diabetic foot ulcer”, and “Diabetic ulcer”. We included all English literatures with year of publication from January 2006 to November 2016; studies comparing honey with other substances; and patients with DFUs. Qualitative assessment of these studies were scored using Jadad Scale. Result : A total of 5 studies involving 517 participants were included. None of 5 studies obtained full Jadad score in quality assessment due to lack of description on randomization method, blinding and dropouts. Three studies reported significantly shorter mean duration of wound healing in honey dressing compared to normal saline and alginate dressing. Other 2 studies reported insignificant difference compared to povidone iodine, although honey still has shorter mean duration of wound healing. Two studies reported less pain during dressing changes in honey dressing group. Conclusion : Honey dressing was superior than control group (normal saline, alginate, and povidone iodine) in reducing mean duration of wound healing in DFU patients. It was also proven to cause less pain during dressing changes. Due to high heterogeneity we are unable to carry out a meta-analysis.

A Cetylpyridinium Chloride Oral Rinse Reduces Salivary Viral Load in Randomized Controlled Trials.

Evaluating the antiviral potential of commercially available mouthrinses on SARS-CoV-2 holds potential for reducing transmission, particularly as novel variants emerge. Because SARS-CoV-2 is transmitted primarily through salivary and respiratory secretions and aerosols, strategies to reduce salivary viral burden in an antigen-agnostic manner are attractive for mitigating spread in dental, otolaryngology, and orofacial surgery clinics where patients may need to unmask. Patients (n = 128) with confirmed COVID-19-positive status within 10 days of symptom onset or positive test result were enrolled in a double-blind randomized controlled trial of Food and Drug Administration-approved mouthrinses containing active ingredients ethanol, hydrogen peroxide, povidone iodine, chlorhexidine gluconate, cetylpyridinium chloride (CPC), or saline. The CPC, ethanol, and sterile water rinses were followed in a second double-blind randomized controlled trial (n = 230). Participants provided a saliva sample before rinsing (baseline) and again at 30 and 60 min after rinse. Quantitative polymerase chain reaction was used to determine salivary SARS-CoV-2 viral load at all time points. An adjusted linear mixed-effect model was employed to compare viral load after rinsing relative to baseline. The rinse containing CPC significantly reduced salivary SARS-CoV-2 viral load 30 min postrinse relative to baseline (P = .015), whereas no other rinse significantly affected viral load at 30 min after rinsing. At 60 min postrinsing, no group had a significant reduction in SARS-CoV-2 copy number relative to baseline, indicating a rebound in salivary viral load over a 1-hour window. Participants indicated a fair to good rinsing experience with the CPC product and high willingness to use oral rinses before and during dental and medical health care visits. Our findings suggest that preprocedural oral rinsing could be implemented as a feasible, inexpensive approach to mitigate spread of SARS-CoV-2 and potentially other enveloped viruses for short periods, which is relevant to clinical procedures involving the nasal and oropharyngeal region. Rinsing with a cetylpyridinium chloride-containing mouthrinse can significantly reduce salivary SARS-CoV-2 viral load for up to 30 min; patients are willing to use mouthrinses in medical and dental settings to limit transmission risk in clinics.

Efficacy of 0.2% povidone-iodine and 0.1% polyhexamethylene biguanide as preoperative antiseptics in equine ophthalmic procedures.

This retrospective study evaluates the efficacy of povidone-iodine (PI) and polyhexamethylene biguanide (PHMB) as preoperative antiseptics in equine ophthalmic procedures. Horses that underwent routine ophthalmic surgery and procedures. Data were collected retrospectively from the medical records of equine patients undergoing ophthalmic procedures. Inclusion criteria were sampling for aerobic microbial culture at three different time points (T0: pre-irrigation, T1: post-irrigation, and T2: postoperatively) and T0 showing bacterial growth. Microbiological outcomes were assessed semi-quantitatively by creating a scoring system to describe the bacterial load. Furthermore, the species detected were evaluated. Poisson regression analysis was performed to evaluate the efficacy of the disinfectants. Eighty eyes (75 horses) met the inclusion criteria, with 36 cases being aseptically prepared with PI and 44 with PHMB. Both antiseptics significantly reduced the bacterial load and number of bacterial species (p < .001) between time points T0 and T1, and T0 and T2. PHMB showed a reduction in the bacterial load by 64% (CI: 51%-73%) whereas PI reduced it by 48% (CI: 36%-58%) between time points T0 and T1. The reduction in the number of bacterial species between time points T0 to T1 was significantly greater in the PHMB group (85%, CI: 70%-93%), compared to PI (47%, CI: 26%-62%). Both PHMB and PI reduced the bacterial load and number of species on the ocular surface and eyelids significantly, with 0.1% PHMB being superior to 0.2% PI. Therefore, PHMB can be considered as a good alternative in preoperative antisepsis in equine ophthalmic procedures.

Preoperative skin asepsis in bovine surgery: an outcome-blinded 3-arm randomized clinical trial under non-sterile operating room conditions.

Surgical site infections (SSI) following clean abdominal surgery in cattle pose significant economic and welfare concerns. Preoperative skin asepsis aims to minimize microbial load over the surgical field before and throughout surgery to minimize its risk. While chlorhexidine (CHX) and povidone-iodine (PVI) are commonly used antiseptics for this purpose, our study introduces the so far unexplored use of octenidine (OCT) in veterinary surgery. We compared in a single-center, prospective, randomized, outcome-blinded, 3-arm trial the effectiveness of an OCT-based protocol to CHX- and PVI-based protocols. Cattle aged 2 years or older, needing a clean standing flank laparotomy (e.g., exploratory laparotomy, right flank omentopexy, left flank abomasopexy), were eligible. Exclusion criteria comprised skin abnormalities, recent antibiotic use, or debilitating conditions with systemic involvement or distant site infections. Patients were randomized 1:1:1 with concealed allocation using unique identifiers. Skin bacterial reduction (immediate [IRF] and delayed [DRF] reduction factors), SSI rate, and wound scores were evaluated. Wound scores were rated on a 0 to 6 scale, considering the presence and severity of discharge and swelling. Out of 373 assessed cattle, 126 were included and randomized: PVI (n = 42), CHX (n = 41), OCT (n = 43). All protocols significantly reduced bacterial counts, with PVI exhibiting lower IRF. No significant differences were observed in DRF. The summer season and duration of surgical procedures had a negative impact on IRF and DRF in all groups, respectively. Nine of 118 patients (7.6%) with complete follow-up developed SSI. Higher wound scores were associated with development of SSI. Wound scores ≥3 at day 10 postoperatively predicted SSI with high sensitivity and specificity. Microbial flora in SSI included typical skin bacteria and opportunistic pathogens. All protocols met minimum FDA standards in reducing bacterial colonization. While limited by sample size and single-center design, this study confirms the OCT-based protocol as a valuable option for preoperative skin asepsis in clean abdominal bovine surgery.

Efficacy of 1% Povidone-Iodine in the Treatment of Anterior Blepharitis-Randomized Single-Center Controlled Trial.

Background: Anterior blepharitis (AB) is a chronic eyelid inflammation with no definitive cure. Objectives: To assess the safety and efficacy of a 1% povidone-iodine (PVI) ophthalmic solution lid scrub compared to formulated eyelid wipes in treating AB. Design: A prospective, randomized, controlled, observer-masked, paired-eye trial. Methods: Sixty-three AB patients were randomly assigned to a 30-day treatment in which one eye underwent a daily lid scrub with 1% PVI solution (1% PVI group), while the fellow eye was treated with formulated eyelid wipes (control group). Clinical outcomes, such as blepharitis signs, tear breakup time, and corneal staining, were evaluated at study enrollment and exit visits. Symptom assessments utilized the visual analog scale (VAS) per eye and the ocular surface disease index (OSDI) questionnaire. Results: Fifty-two patients (mean age 62.3 years, 53.8% females) completed the treatment, while seven patients were lost to follow-up, three were non-compliant, and one sustained an eye trauma. After 30 days, both the 1% PVI and control groups exhibited significant improvements in symptoms, blepharitis signs, and corneal staining (p < 0.05). The 1% PVI scrubs were equally effective as eyelid wipes in most outcomes (p = 0.480) and superior in alleviating eyelid erythema (p = 0.007). Only the 1% PVI group showed a positive correlation between OSDI and VAS score improvements (r (52) = 0.353, p = 0.01). No adverse events related to either treatment modality were reported. Conclusions: A 1% PVI solution is an effective, safe, and well-tolerated treatment option for AB and is superior to formulated eyelid wipes in several subjective and objective measures.

A COMPARATIVE STUDY OF PREVALENCE OF SURGICAL SITE INFECTION USING POVIDONE IODINE VS CHLORHEXIDINE ALCOHOL IN PREOPERATIVE SKIN PREPARATION IN ABDOMINAL HERNIAS

Background: Surgical site infections (SSIs) are among the most common complications following abdominal surgeries, including hernia repairs. These infections significantly contribute to patient morbidity and healthcare burden, especially in resource-limited settings. Preoperative skin antisepsis is a critical factor in SSI prevention, with agents such as povidone iodine (PI) and chlorhexidine alcohol (CA) frequently used. However, their comparative efficacy in reducing SSI rates remains an area of clinical interest, necessitating further exploration. Objective: To compare the prevalence of SSIs in patients undergoing preoperative skin preparation with povidone iodine versus chlorhexidine alcohol during abdominal hernia repair. Methods: This comparative non-randomized controlled trial was conducted at CMH, Rawalpindi, from May 2022 to February 2023. A total of 300 patients scheduled for hernia repair were enrolled and divided equally into two groups: group A (PI) and group B (CA). Group allocation was performed using a single-blinded technique to minimize bias. Preoperative skin preparation was conducted with a 10% PI solution for group A and a CA solution (2% chlorhexidine in 70% alcohol) for group B. Patients were followed up for 30 days post-surgery to evaluate the presence of SSIs, defined as purulent discharge, fever, elevated white blood cell count, swelling, or erythema at the surgical site. Data were analyzed using SPSS version 22, with statistical significance set at p ≤ 0.05. Results: The study included 300 patients with a mean age of 40.42 ± 8.71 years, of whom 124 (41.30%) were male and 176 (58.70%) were female. The overall SSI frequency was 69 (23.00%). SSI was significantly higher in the PI group compared to the CA group, with rates of 34.00% (51/150) versus 12.00% (18/150), respectively (p &lt; 0.001). Conclusion: Chlorhexidine alcohol is significantly more effective than povidone iodine in reducing the prevalence of SSIs in abdominal hernia surgeries. Its use should be preferred for preoperative skin antisepsis to improve surgical outcomes.