Povidone-iodine Research Articles

The Effect of Gargling Areca Nut Extract (Areca catechu L) 2,5% Against Plaque pH and Saliva pH

ABSTRACTThe most common dental and oral health problems are dental caries and periodontal disease caused by dental plaque. Dental plaque is a soft deposit consisting of microorganisms found on a matrix that is formed and adheres tightly to the tooth surface. Bacteria in plaque will metabolize food waste, especially the type that can be fermented so that it will produce acid. The acid produced will lower the plaque pH to 4.5-5.0 wthin 1-3 minutes and return to normal at pH 7 within 30-60 minutes. Plaque buildup on the tooth surfaces is related to plaque pH salivary pH. The continuous decrease in plaque pH and salivary pH will cause demineralization. The purpose of this study was to determine the effect of gargling betel nut extract (Areca catechu L) 2.5% on plaque pH and salivary pH.The study was a quasi-experiment research with two group pretest-posttest design. The sample used in this study were 16 samples, 6th graders at SDN Pontianak Utara using the Total Sampling method. The sample was instructed to rinse with a 2.5 % betel nut extract moutwash solution and measure the plaque pH and salivary pH before and after gargling. The control group rinsed with 1% povidone iodine (Betadine Moutwash). Data analysis using the tes Wilcoxon to find out the difference between the influence variables and the affected variables.The results of this study based on the test were Wilcoxon test, the results showed that the average plaque pH before and after gargling with betel nut extract was 2.5% 7.06 and 7.22 p-value = 0.000 (p 0.05). The average pH of saliva before and after gargling a 2.5% betel nut extract solution was 6.56 and 5.59 p-value = 0.000 (p 0.05). So it can be concluded that gargling 2.5% betel nut extract solution has an effect on changes plaque pH and salivary pH.

The efficacy of multifaceted versus single anesthesia work area infection control measures and the importance of surgical site infection follow-up duration

BackgroundEarlier a randomized trial showed efficacy of a multifaceted intervention approach for reducing surgical site infection: hand hygiene, vascular care, environmental cleaning, patient decolonization (nasal povidone iodine, chlorhexidine wipes), with feedback on pathogen transmission. The follow-up prospective observational study showed effectiveness when applied to all operating rooms of an inpatient surgical suite. In practice, many organizations will at baseline not be using conditions equivalent to the control groups but instead functionally have had ongoing a single intervention for infection control (e.g., encouraging better hand hygiene). Organizations also differ in how well and long they survey every surgical patient for postoperative surgical site infection. Thus, estimation of the expected net cost savings from implementing multifaceted intervention depends on the relative efficacy of multifaceted approach versus single intervention approaches and on the incidence of surgical site infection, the latter depending itself on the monitoring period for infection development. MethodsThe retrospective cohort analysis included 4865 patients from two single intervention and two multifaceted studies, each of the four studies with matched control groups. We used Poisson regression with robust variance to estimate the relative risk reduction in surgical site infections for the multifaceted approach versus single interventions and, with 30-day follow-up versus ≥60-day follow-up for infection. ResultsThe multifaceted approach was associated with an estimated 68% reduction in postoperative surgical site infections relative to single interventions (risk ratio 0.32, 97.5% confidence interval 0.15–0.70, P = 0.001). There were approximately 2.61-fold more surgical site infections detected with follow-up for at least 60 days of medical records relative to 30 days of records reviewed (97.5% CI 1.62 to 4.21, P < 0.001). ConclusionsAn evidence-based, multifaceted approach to anesthesia work area infection control can generate substantial reductions in surgical site infections. A follow-up period of at least 60-days is indicated for infection detection.

Effect of Honey Dressing on Wound Healing among Patients with Diabetic Foot Ulcer at Al-Ahsa, Saudi Arabia

Background: Diabetic foot ulcer (DFU) is a serious infection in people with diabetes mellitus. DFU is caused by vascular disease with diabetic neuropathy, and severe DFU leads to disability or even death. Mostly, povidone iodine dressing (PID) is used for DFU. The honey dressing (HD) may also improve wound healing in DFU as a complementary therapy. Aim: The study aimed to determine the effect of HD on the wound-healing process for DFU. Materials and Methods: A prospective observational study was conducted in the diabetic centres of selected hospitals in eastern Saudi Arabia. A total of 126 patients with DFU below grade three according to Wagner’s classification were selected by randomization and equally divided into HD (n = 63) and control (n = 63) groups. The patients were followed up with regularity, and 60 from each group were analysed, because the remaining patients lost their follow-up. Demographic variables and clinical parameters including random blood sugar and haemoglobin A1C were measured at the initial visit before intervention. The Bates-Jensen wound assessment tool was used before and after the intervention. Intervention group received HD and control group received PID for 6 weeks. The results are presented using frequency, mean, chi-squared test, independent ‘t’ test and Wilcoxon signed-rank test. Results: Among 120 patients, the demographic variables, and clinical parameters in the HD and control were homogeneous. The overall mean wound score was 41.07 ± 2.95 and 29.78 ± 2.2 before and after the intervention in the HD group respectively which was significant (p &lt; 0.0001). Mean score of control was 41.13 ± 2.43 before intervention and 38.53 ± 3.29 after intervention which was also significant (p = 0.00062). Conclusion: HD is best alternative cost-effective dressing method that promotes faster healing in DFU. It should be further promoted in healthcare settings.

Practical povidone iodine catalyzed transamidation from primary amides and amines

Non-harmful Povidone iodine (PVP-I) was applied in the transamidation to gain N-substituted amides from various primary amides and amines. Diverse aromatic, heterocyclic and aliphatic primary amides/amines were applied in our developed method and more than 45 N-substituted amides were obtained with excellent yields in most cases. Several drugs such as Melatonin and Efaproxiral were successfully acquired with a better performance than those previous reported results.

Oral manifestations associated with concurrent CMV and HSV-1 in children with cerebri abses: rare case report

Herpes simplex virus-1 (HSV-1) and cytomegalovirus (CMV) are members of the human herpes viridae (HHV) family that can infect and give oral manifestations. This case report aims to discuss the oral manifestations of HSV-1 and CMV infection in a child with cerebral abscess. A 7-year-old boy was referred from the Department of Pediatrics to the Department of Oral Medi-cine with complaints of sore mouth sores, especially when eating, three days ago.Extraoral examination revealed that the lips were dry and peeling. Intraoral examination on the dorsum and lateral of the tongue, buccal mucosa and labialmucosa there is white plaque spread, can be scraped and leave an area of ​​erythema. Many ulcers were found, shallow oval in shape, yellowish white in color,surrounded by a diffuse reddish border, varying in size 0.1-0.5 cm in the oropharynx, tonsils, and other oral mu-cosa. The blood laboratory examinations showed a decrease in the value of leukocytes, albumin, creatinine, and sodium, while the monocyte and SGOT values ​​were high, with anti-HSV-1 IgG and reactive anti-CMV IgG. The established diagnosis was acute pseudomembranous oral candidiasis with intraoral HSV-1 and CMV infection. The treatment given is cleaning the entire surface of the oral cavity by gargling with 1% povidone iodine mouthwash 2 times a day, an hour break followed by administration of 1 mL oralsuspension of nystatin 4 times a day, and applying a thin layer of vaseline to the lips 2 times a day. The oral lesions healed on day-10. It was concluded that the oral manifestations can occur in patients with HSV-1 and CMV virus infections.

1911. A Pilot Study to Evaluate the Effectiveness of Nasal and Oral Povidone Iodine in Reducing the Burden of Severe Acute Respiratory Syndrome 2 RNA in Patients with COVID-19

Abstract Background Nasal and oral application of topical antiseptics such as povidone iodine could potentially reduce the risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, limited information is available on the efficacy of such agents in reducing the burden of SARS-CoV-2. Methods We conducted a pilot non-blinded, randomized trial to compare the effectiveness of 3 doses of povidone iodine (each dose with 10% intranasal and 1% gargle) administered every 8 hours versus the control with phosphate-buffered saline in reducing the burden of SARS-CoV-2 RNA in the nares and oropharynx of patients with COVID-19. Swabs were used to collect anterior nares and oropharynx samples before the first and second doses and 8 hours after the final dose (24 hours after the initial dose). Real-time polymerase-chain reaction (RT-PCR) was used to assess the burden of viral RNA. Analysis of variance was used to compare cycle threshold values for povidone iodine versus control patients. Subjects were surveyed about adverse reactions to treatment. Results As shown in the figure, SARS-CoV-2 cycle thresholds were similar in the povidone iodine (N=10 subjects) and control (N=8 subjects) groups prior to treatment. After initiation of treatment, there was no significant difference in cycle thresholds for the povidone iodine versus control subjects (P &amp;gt;0.05). No adverse effects of treatment were reported. Effect of intranasal and oral application of povidone iodine versus phosphate-buffered saline on nasal and oropharyngeal SARS-CoV-2 RNA. Error bars show standard error. Conclusion Our findings suggest that that nasal and oral application of povidone iodine have limited effectiveness in reducing the burden of SARS-CoV-2. Future studies are needed to assess for effectiveness of more frequent dosing intervals and to determine if povidone iodine reduces recovery of viable virus by culture. Disclosures All Authors: No reported disclosures.

429. Identifying Barriers to Compliance with a Universal Inpatient Protocol for Staphylococcus aureus Nasal Decolonization with Povidone-Iodine

Abstract Background Intranasal povidone-iodine (PI) is a recommended strategy for universal decolonization in high-risk patients (ICU and those with central venous or midline catheters) to reduce hospital-associated Staphylococcal infections. Few studies have evaluated implementation challenges and barriers to successful performance of inpatient intranasal decolonization programs. Methods We surveyed adult acute care unit nurses at an academic medical center in March 2022, approximately 14 months after implementation of a universal decolonization standard operating procedure (SOP). The anonymous, voluntary REDCap® survey evaluated domains focused on patient identification, education, training, resources, application, and patient acceptance using Likert scale ratings. Results Among 248 respondents, most were new to nursing (54.4% with 0-4 years of experience) and worked in non-ICU units (61.5%). Only 60.5% reported receiving training on how to perform intranasal PI (hands-on 48.6%, computer/electronic module 25.7%, both 20.9%). Nurses who received training indicated moderate to strong confidence in their ability to perform intranasal PI decolonization (89.2%). A majority cited a good understanding of the rationale for use and identified patients appropriately. Low rates were reported for performing decolonization per the SOP (49%), with barriers including inadequate supplies (35.1%), lack of a readily available copy of the SOP (69%), difficulty swabbing with nasal devices in place (41.5%) and time constraints from other patient duties. Nurses perceived that only 49.2% of patients had a moderate or strong understanding of why PI decolonization was performed, and most were unwilling to undergo intranasal PI (59.1%). Other issues included tracking PI application within the electronic medical record (EMR), limited nurse knowledge of PI effectiveness, patient refusal despite education, and overall frontline personnel burnout. Conclusion Gaps in nursing and patient education should be prioritized during and after implementation to improve fidelity, particularly with frontline burnout from COVID-19. Streamlined tracking and ordering of PI on the EMR may ease nursing workflow. Disclosures Thomas R. Talbot, III, MD, MPH, OmniSolve: Board Member.

1232. Mupirocin Susceptibility of Staphylococcus aureus (SA), 2022: Is It Time for Change in MRSA Decolonization?

Abstract Background Nasal decolonization with mupirocin has been a commonly used strategy for the prevention of surgical site infections (SSIs) due to SA. We recently noted an increase in SSIs due to SA despite the use of mupirocin, including a case of post-operative mupirocin-resistant MRSA infection despite intranasal mupirocin. We therefore evaluated the mupirocin susceptibility of SA at Stamford Hospital to determine the optimal regimen for decolonization. Methods SA isolates were recovered from clinical and screening samples received in the microbiology laboratory from 8/1/2020 to 2/28/2022. Mupirocin susceptibility was determined using e-tests and a standardized inoculum on Mueller-Hinton agar. Isolates were categorized as “susceptible” (MuS) with minimum inhibitory concentrations (MIC) ≤4 mcg/ml or resistant (MuR) with MIC values ≥8mcg/ml. Resistant strains were further divided into low-level resistance, with MIC values from 8 to 256 mcg/ml, and high-level resistance, with MIC values &amp;gt;256/ml. SA isolates were identified and tested for susceptibility by usual Clinical Laboratory Standards Institute (CLSI) criteria. Results 223 unique SA isolates from 218 patients were tested. Patients ranged in age from newborn to 94 years. Twenty-four SA isolates (10.8%) were resistant to mupirocin (20 MRSA and 4 MSSA). Of the 24 MuR strains, 19 (79.2%) isolates demonstrated high-level resistance. MRSA strains were more likely to be resistant (22.5% were MuR) than MSSA strains (3.0% were MuR) (p&amp;lt; 0.001). MuR strains did not differ from MuS strains with respect to patient age, sex, race, site of isolation, infected versus colonized, community-acquired versus hospital-acquired or inpatient/out-patient location. Conclusion Preventing surgical site infections is challenging. Decolonization with mupirocin nasal ointment has been a common component of preoperative optimization. However, the emergence of resistance would render mupirocin suboptimal and other regimens might be preferred. In our study, less than 80% of MRSA strains were MuS. These findings are concerning and have led us to reevaluate our current decolonization strategy. In patients colonized with MRSA at high risk for infection (e.g. total joint replacement), intranasal povidone iodine may be preferable to mupirocin. Disclosures All Authors: No reported disclosures.

A systematic review and meta-analysis comparing intrawound vancomycin powder and povidone iodine lavage in the prevention of periprosthetic joint infection of hip and knee arthroplasties

BackgroundFocus on reviewing a vigorous research effort to improve the safety profile of vancomycin powder (VP) and its optimal dose in reducing periprosthetic joint infection (PJI) is the need of the hour. This systematic review and meta-analysis attempt to explore the ongoing use of VP and VP + povidone iodine (PI) lavage to prevent PJI of hip/knee arthroplasties and highlights its challenges among the orthopedic community about the existence of the major organism and its frequency in total joint arthroplasty (TJA) patients. MethodsWe searched PubMed/MEDLINE, EMBASE databases regarding the outcomes of vancomycin powder (VP) and VP + povidone iodine (PI) combination in preventing periprosthetic joint infection of hip and knee arthroplasties. ResultsIn 5 of 7 studies, the combination of vancomycin powder (VP) and povidone iodine (PI) lavage have shown a lower risk of periprosthetic joint infection (PJI) in acute and high-risk hip and knee arthroplasties patients, with less or without serious adverse events and readmissions; while four of seven studies using VP-only found increasing rates of PJI in primary total knee arthroplasty and partial hip replacement in elderly patients with comorbidities, and significantly causes aseptic wound complications compared to the control group. ConclusionsIntra-articular vancomycin powder (VP) and povidone iodine (PI) lavage showed a significant reduction of periprosthetic joint infection in primary and revision total joint arthroplasty. Before its widespread use in clinical settings, prospective randomized studies and, most importantly, its long-term efficacy and safety are recommended.

The effect of chlorhexidine, povidone‐iodine and betadine antiseptic eye drops on cultured human conjunctival goblet cell survival

AbstractPurpose: To compare the effect of ocular antiseptic treatment in terms of 0.05% aqueous chlorhexidine, 5% povidone‐iodine (PI) and 5% betadine on cell viability and mucin secretion of primary cultured human goblet cells.Methods: Cell viability of primary cultured human goblet cells was analysed using lactate dehydrogenase (LDH) and tetrazolium dye (MTT) colorimetric assays. Expression of mucin was visualized by immunohistochemical staining of MUC5AC.Results: According to the LDH assay, PI and betadine significantly reduced goblet cell survival compared to controls (mean cell survival 23% ± 6 and 23% ± 7, respectively) (p &lt; 0.05), whereas chlorhexidine (mean cell survival 78 ± 17) did not significantly affect goblet cell viability. Similar results were obtained from the MTT assay, where PI and betadine caused a significant loss of goblet cells (mean cell survival 26% ± 12 and 26% ± 13, respectively) (p &lt; 0.05), and chlorhexidine caused a non‐significant loss of goblet cells compared to controls (mean cell survival 79% ± 8).Conclusions: PI and betadine, the most used antiseptic treatments prior to ocular surgery, are significantly more cytotoxic on conjunctival goblet cells compared to chlorhexidine.

Topical sevoflurane corneal toxicity: in vitro study

AbstractPurpose: The purpose of the study is to investigate the cytotoxic effect of sevoflurane (SF) and povidone‐iodine (PI) on cultured rabbit corneal epithelial cells in vitro.Methods: We evaluated the cytotoxic effect of a 5 min exposition of SF, PI and balanced saline solution (BSS) using an in vitro rabbit corneal cell culture model (Short‐Time Exposure Test Method). In order to quantify cytotoxicity MTT assay was employed. Repeated exposition of SF was evaluated as well as cell viability after different recovery times (30 min, 60 min and 1 h). Statistical results were obtained with Kruskal‐Wallis test and Conover post‐hoc test.Results: The median of cell viability of SF was 85.29%, PI 0.52% and BSS 97.29%, with statistically significant differences between them (p = 0.005). After a 5 minute recovery, the median of cell viability for SF was 87.77%, 74.48% after 30 minutes and 76.66% after 60 minutes. After a double exposition it was 70.59%, with no statistically significant differences between single and double exposition (p = 0.18).Conclusions: No corneal toxicity of SF was observed, in contrast with PI. Cellular damage did not change with longer recovery time or double exposition to SF.ReferencesSevoflurane (SF) has been proved recently to have analgesic/antimicrobial effects. (1, 2) We believe of interest to study the effect of SF in the ocular surface. As there is no literature about this topic, in vitro studies are required before in vivo tests.1. Chu CC, Wu SZ, Su WL, Shieh JP, Kao CH, Ho ST, et al. Subcutaneous injection of inhaled anaesthetics produces cutaneous analgesia. Can J Anesth Can Anesth. 2008;55(5):290–4.2. Manuel Gerónimo Pardo, María Martínez Serrano, Ángel Martínez Monsalve, Juan Luis Rueda Martínez. Usos Alternativos del Sevoflurano: Efecto Analgésico Tópico. Rev Electrónica AnestesiaR [Internet]. 2012 [cited 2019 Apr 15];4(5). Available from: http://revistaanestesiar.org/index.php/rear/article/view/373

Does mouthwash degrade the force of orthodontic latex elastics?

With the surge of COVID-19 pandemic, orthodontists have recommended the use of mouthwashes. However, this product frequently contains ingredients that can modify the mouth's pH and elastic force. This study examined the influence of mouthwashes on latex elastic force deterioration. One hundred orthodontic latex elastics (1/4”) were separated into five groups: control, zinc sulfate 0.2%, chlorhexidine 0.2%, sodium fluoride 0.2%, and povidone–iodine 1%. The samples were stretched to 19.05 mm, stored in artificial saliva solutions, and incubated. Groups 2–5 tested mouthwashes for 60 seconds every 12 hours and then reverted to artificial saliva. Force was measured using a five-times-activated tension gauge. Elastic force was tested at five-time intervals: baseline, 1, 6, 12 and 24 hours. The statistical analysis included two-way ANOVA and the Tukey post–hoc test. Results showed statistical differences for the time intervals and force degradation of orthodontic latex elastics (p&amp;lt;0.05). The majority of force loss occurred within six hours of extension and immersion. Mouthwashes had no influence on the reduction in elastic force (p&amp;gt;0.05). The force degradation of orthodontic latex elastics was unaffected by mouthwashes. The lowest force degradation was generated by povidone–iodine, followed by zinc sulfate, sodium fluoride, and chlorhexidine.

Effect of topical ethanolic extract of noni leaf on post-extraction wound by observation of wound diameter and osteoblast cells

Objective: The aim of this study is to determine the effect of noni leaf ethanol extract gel on post extraction wound of rabbit teeth observed from wound diameter and osteoblasts cell count. Tooth extraction is one of the treatments performed in the oral region that cause wound. Application of substance or medicine might help accelerate and improve wound healing.&#x0D; Material and Methods: Twenty-four rabbits divided into three groups: negative control, positive control with 10% povidone iodine, and treatment group with 10% ethanol extract gel of noni leaf. The tooth was extracted from the mandibular left incisor. The diameter of the wound area was examined on day 0, 3, 7, and 14 while the osteoblasts cell count was obtained from rabbits’ specimen in each group on 14th day. Measurement of wound diameter was done by using calipers, while the number of osteoblasts were calculated using toluidine blue histochemistry stain and light microscope with 400x magnification.&#x0D; Results: The ratio of wound diameter were better in treatment group with significant difference (p=0.048) while osteoblasts cell count were not significantly different among all groups.&#x0D; Conclusion: Topical application of noni leaf had an effect in decreasing mucosal wound diameter but there was not any evidence yet that it was increased osteoblast cells on socket wound healing process.

Topical sevoflurane ocular toxicity: in vivo study

AbstractPurpose: To determine sevoflurane (SF) ocular toxicity in an animal model and compare the results with the changes induced by common ocular substances: Povidone Iodine 5% (PI) and salt solution (SS).Methods: Twelve rats (24 eyes) and 3 rabbits (6 eyes) where included. Eyes were randomized, receiving a single 0,1 ml dose of SF, PI or SS. After instillation, eyes were evaluated using Draize test at different time frames. A histopathological (HP) study was also performed.Results: Keratitis was the only finding identified in the animals. In rats, it was observed in 16/24 eyes (8 in SS, 4 in SF and 4 in PI group). Only the keratitis observed after SS and PI instillation showed statistically significant differences, with a higher incidence in PI group (p = 0.012). Similar results were observed in rabbits: keratitis was present in 5/6 eyes (3 in SF and 2 in BSS group), but no significant differences were observed in any group at any time of study. The risk ratio (=1) did not show a higher risk of keratitis with any substance. In HP study, only mild inflammatory changes were observed.Conclusions: Topical administration of SF has shown to be safe for the eye surface of animal model.ReferencesRecent findings suggest sevoflurane role as an analgesic, antiseptic and wound‐healing agent. Nevertheless, previous to study these effects on the eye, it is necessary to perform and toxicological test. This is the first study performed in vivo to evaluate sevoflurane ocular toxicity.

English

Acacia nilotica (Linn) is an important medicinal plant, found in Africa, the Middle East, and the Indian subcontinent as well as in Sokoto State, Nigeria. It has been utilized to treat wounds and intestinal disorders among other uses. It has been estimated that nearly 6 million people suffer from chronic wounds worldwide. Even though several conventional drugs are known to increase healing in different kinds of injuries, most are complicated, expensive, and limited in activity. Hence, in this study the stem back crude methanolic extract of A. nilotica was evaluated for wound healing activity using the wound excision model. The plant&#39;s stem bark was extracted by maceration using distilled water and methanol to obtain a crude methanol extract (CME). The CME was screened phytochemically and prepared into ointment before subjecting to wound healing assay using the excision wound model in Wister albino rats. The results showed the presence of rich phenolic phytoconstituents, especially of tannins and saponins which were attributed to aid wound healing based on literature. Consequently, the wound healing activity of 10% CME was comparable significantly (P&lt;0.05), to that of povidone-iodine (5% w/w), while that of 2.5 and 5% were less. The study demonstrated that topical application of CME hastens wound healing and thus provided proof of its folklore use for wound healing. Key words: Contraction, epithelisation, extract, phytoconstituents, povidone iodine, wound.

Effectiveness of Preoperative Vaginal Cleansing with an Antiseptic Solution among Cesarean Patients

Cesarean section is thought to be one of most common surgical method for delivery of baby, perhaps most frequent procedure by obstetricians. The most important factor after Cesarean section to return to normal life functions and look after new born is Infectious morbidity. Objective: To compare the Effectiveness of preoperative vaginal cleansing with an antiseptic solution among cesarean patients. Methods: This Comparative study was done in department of Obstetrics and Gynecology, Sheikh Zayed Hospital Chandka Medical College Larkana from 20 June 2019 and the last at 19 December 2019.we included 336 patients fulfilling the inclusion criteria. Informed consent was taken. The data were collected on prepared proforma in two groups as A group (intervention group) and B (control group) respectively. Results: Study includes 336 patients with mean age of 26.29±4.7 and 26.52±5.9 years, divided in two groups 168 in each group A and B respectively. Out of 336, 14(4.2%) developed endometritis, 8(2.4%) developed wound infection and 16(4.8%) developed fever. The composite morbidity was 11.3%; with 26.3% of group A and 73.6% of group B. Conclusions: This study showed that the use of 10% Povidone iodine was significant in reducing post op morbidity. Cleansing of vagina with an antiseptic solution is easy intervention before cesarean section

Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia?

The reduced use of antimicrobial drugs has been recommended worldwide, according to the global action for antimicrobial resistance published in 2015 by the World Health Organization. In this study, we retrospectively reviewed the incidence of surgical site infection in consecutive patients with cataract surgeries at a single hospital in the 6-year process when prophylactic systemic antibiotics were reduced in a step-by-step manner. The entire study period from 2016 to 2022 was divided into five stages, based on the use of systemic antibiotics. In stage 1 with 649 cataract surgeries, an intravenous drip infusion of cefazolin 1 g was given at surgery, followed by oral cefdinir 100 mg in the evening on surgery day and three times for two postoperative days. In stage 2 with 541 cataract surgeries, oral cefdinir 100 mg was given in the late morning before surgery, in the evening, and three times (300 mg in total) for two postoperative days. In stage 3 with 103 cataract surgeries, oral levofloxacin 500 mg was given in the late morning before surgery and once in the morning for two postoperative days. In stage 4 with 545 cataract surgeries, oral levofloxacin 500 mg was given only in the late morning before surgery. In stage 5 with 311 cataract surgeries, no systemic antibiotics were given. As common procedures in all stages, moxifloxacin eye drops were given four times daily as topical antibiotics in the 3 days before surgery and about 2 weeks after surgery. At surgery, the ocular surface was frequently irrigated with saline-diluted povidone iodine at 0.5% working concentration. No postoperative infection was recorded in any stage. This study showed neither harm nor risk in reduced use and, consequently, no use of prophylactic systemic antibiotics in cataract surgery as far as local precautionary measures were secured.

How does povidone iodine alone or with dexamethasone compare with placebo for adults with epidemic keratoconjunctivitis?

How does povidone iodine alone or with dexamethasone compare with placebo for adults with epidemic keratoconjunctivitis?

Keller Funnel Efficacy in "No Touch" Breast Augmentation and Reconstruction: A Systematic Review.

A systematic review of PubMed, Embase, the Cochrane database, and Google Scholar was performed between 2005 and 2021. All clinical-based, retrospective and prospective studies utilizing the Keller funnel method for breast implant insertion were selected. Six studies were identified for evaluation: five were retrospective cohorts and one was a prospective trial. No randomized controlled trials were found. Outcomes reported included lower rates of capsular contracture (RR, 0.42; P = 0.0006; 95% CI, 0.25-0.69), shorter incision lengths (35.5 ± 2.1 mm), less insertion time (mean = 6 seconds), and decreased complications, and one paper reported ultimately greater patient satisfaction with outcomes (BREAST-Q Score: 92%). This review suggests that the Keller funnel is a useful method for no-touch breast augmentation and reconstruction surgery. The Keller funnel reduces subsequent capsular contracture rate, surgical time, and incision length and allows for easier insertion. However, our findings support recommendation of a prospective randomized controlled clinical trial with larger population size and follow-up intervals.

Osteolytic metatarsal osteomyelitis regenerated by combined treatment of artificial carbon dioxide foot bathing and povidone–iodine sugar ointment: a case report

BackgroundIn recent years, the number of patients with ischemic skin ulcers due to diabetes mellitus and arteriosclerosis obliterans are increasing. Accordingly, endovascular therapy, drugs, and various wound dressings have been developed and applied to diabetic foot ulcers, and negative-pressure wound therapy, which often requires expensive and burdensome procedures for medical personnel, has also become popular. So simple and minimal invasive home treatment by the patient or their caregiver is required.Case presentationThe present patient (77 years old, male, Asian) had developed left sole ulcers with draining pus that were resistant to conventional treatment, and he suffered from gait disturbance. We report a case of metatarsal osteomyelitis in a patient with diabetes mellitus and arteriosclerosis obliterans, in whom artificial carbon dioxide foot bathing and povidone–iodine sugar ointment were used continuously to promote bone and joint regeneration, and skin ulcer healing.ConclusionsA simple therapeutic intervention with artificial carbon dioxide foot bathing and povidone–iodine sugar ointment can improve not only ischemic skin ulcers, but also the bone and joint regeneration of ischemic limbs. This therapy can lead to a reduction in healthcare costs for a huge number of diabetic patients.