Background and Aim: Preparing the skin for surgery with antiseptics is a standard measure to reduce surgical site infection. This study aimed to evaluate the effect of skin preparation at the surgical site with POVIDONE-IODINE 7. 5% and POVIDONE-IODINE 10% antiseptics with chlorhexidine and POVIDONE-IODINE 10% on the microbial count. Methods: This clinical trial study was performed on 80 patients with elective abdominal surgery. Patients were divided into two groups by simple random methods and proportional allocation of skin preparation with POVIDONE-IODINE 7. 5% and 10% antiseptics or chlorhexidine and POVIDONE-IODINE 10% antiseptics. On the day of surgery, the culture sample was taken before the primary skin preparation, then the primary preparation was done with POVIDONE-IODINE 7. 5% or chlorhexidine in alcohol, then the second culture was taken, the secondary skin preparation was done in both groups with POVIDONE-IODINE10% and then the third culture was taken. Specimens of cultures were taken on a blood agar plate and McConkey plate for the examination of microbial count and type, were immediately transferred to the laboratory. Results: The mean differences in microbial counts before and after skin preparation with POVIDONE-IODINE 7. 5% and POVIDONE-IODINE 10% antiseptics were significant (P=0. 001). Also, mean differences in microbial counts before preparation with after skin preparation with chlorhexidine in alcohol antiseptics and POVIDONE-IODINE 10% were significant (P<0. 001) and in general, both antiseptic groups significantly reduced microbial counts. In comparing the effect of the two groups on the mean microbial count, although the skin preparation with chlorhexidine in alcohol and POVIDONE-IODINE 10% antiseptics was better than POVIDONE-IODINE 7. 5% and POVIDONE-IODINE 10% antiseptics, the difference between the two groups was not significant (P=0. 324). Conclusion: Both antiseptic groups were able to significantly reduce the mean microbial counts. Therefore, it is recommended that both antiseptic groups be used to prepare skin for surgery.

Ophthalmia neonatorum is generally defined as conjunctivitis occurring within one month of life. The sources of this infection are environmental organisms or the organisms colonized in the birth canal. Untreated infection can cause blindness, especially if the corresponding organisms areNeisseria gonorrhoeae, or Chlamydia trachomatis.POVIDONE-IODINE ophthalmic solution is an effective antibacterial agent with broad antibacterial and antiviral activity to which no bacterial resistance has been known. It is less expensive and less toxic than the agents currently used to prevent neonatal conjunctivitis. It turns the conjunctiva brown for a few minutes, a characteristic that can serve as an indicator of being properly applied. Because this preparation is not available in Iran, its formulation can be valuable.In this study, the POVIDONE-IODINE ophthalmic solution was prepared in concentration of 2.5%, and then required control parameters such as pH, self-preservation effect, tonicity, sterility, and chemical stability were studied. In this clinical study, one drop of POVIDONE-IODINE ophthalmic solution was instilled in each eye of 475 neonates within 30 minutes of birth.This study demonstrated that POVIDONE-IODINE in concentration of 2.5% is self-preservative against microbial contamination. The pH of solution was adjusted about 5 near to the pH of tear using sodium hydroxide 0.1 N and citric acid 0.5%, because in this pH POVIDONE-IODINE was more stable. Tonicity was measured according to an in vitro hemolytic method. POVIDONE-IODINE 2.5% solution was packaged in amber color bottles, and after ensuring from its sterility, it was used in clinical study. Among the population studied, eye discharge was observed in 2.94 percent in comparison to the control group in which eye discharge was observed in 10.9 percent.In conclusion because of availability, low cast, and good clinical results, a 2.5% ophthalmic solution of POVIDONE-IODINE is desirable to use as a prophylactic agent against ophthalmia neonatorum.

Background: The effectivity of applying antiseptics in preparation of the operative site on the reduction of post-operative infections is not quite clear and controversies exist about the best method for doing this. The aim of this study is to compare the traditional two-stage method of first, washing the site with POVIDONE IODINE scrub and then painting with aqueous POVIDONE IODINE with the method of washing the site only with POVIDONE IODINE scrub.   Materials and Methods: In this retrospective study, patients who had been under knee arthroscopy in 2 separate hospitals by the same surgeon were compared with regard to post operative infection. In one hospital, the operative site was only washed with POVIDONE IODINE scrub, while in the other hospital this same procedure was followed by painting with aqueous POVIDONE IODINE. The primary goal of this study was to identify the patients who had manifested clinical and laboratory signs of superficial or deep infection or septic arthritis one month postoperatively. Results: A total 300 patients were studied in two equal groups. All the patients had only been under diagnostic or curative non-bony operations. No superficial or deep infection or septic arthritis were seen in any of the patients in the two groups.Conclusion: Preoperative preparation of the knee with POVIDONE IODINE scrub is a safe method for prevention of infection and can be used instead of the common two-stage method of using POVIDONE IODINE scrub and then painting with aqueous POVIDONE IODINE since this can decrease the time and cost of surgery.

BACKGROUND: There is still a controversy about the best method for preoperative skin preparation (skin cleaning). The main antiseptic solution used in the cardiac surgery room is POVIDONE IODINE (PI), which is used to prepare the area to be operated on. This study aimed to determine the urinary IODINE level in children (newborns, infants, and toddlers) undergoing (open and closed) heart surgery, in whom preoperative skin preparation was performed using PI solution. METHODS: This study was conducted over eight years on a total of 212 children who underwent cardiac surgery. A form was developed for each patient in which all their details, condition, and type of surgery were recorded. A urine sample was taken after the patients were anesthetized and before they were painted with PI through the urinary catheter that had to be attached to them for the cardiac surgery. The patients were then prepped with PI and draped and the surgery was performed. Afterwards, the second and third urine samples were taken 24 and 48 hours after the surgery from the urine collection bag. The samples were transferred to polyethylene tubes with screw caps in a cold box at-20 °, C and sent to the IODINE reference laboratory of the Endocrinology Research Center of Shahid Beheshti University. The samples were measured using the kinetic colorimetric reaction proposed by Sandell and Kolthoff after the acid digestion of urine. RESULTS: A total of 212 patients (newborns, infants, toddlers) who underwent (open and closed) cardiac surgery entered the study, including 104 (49. 1%) males and 108 (50. 9%) females. The patients ranged in age from 1 day to 14 years (mean = 168 months). The urinary IODINE level was 40. 6±, 21. 9 μ, gr/dl in the first stage (pre-surgery), 204. 1±, 92. 5 μ, gr/dl in the second stage (24 hours’,post-surgery), and 130. 3±, 56. 2μ, gr/dl in the third stage (48 hours’,post-surgery). DISCUSSION: Urinary IODINE levels increased dramatically after PI use, and the second-stage urinary IODINE changes (24 hours’,post-surgery) were in the excessive range according to the WHO classification, and they decreased gradually over the next 24 hours, but did not reach normal levels until 48 hours’,post-surgery. The difference between the samples was significant (P<0. 05) The samples were also separately analyzed by age group (groupA: 0-2 years and group B: 2-14 years), which showed that transcutaneous IODINE absorption and urinary IODINE excretion were high in both age group. CONCLUSION: In children, transcutaneous IODINE absorption following preoperative skin preparation with PI (for cardiac surgery) is so high that its urinary excretion reaches an excessive level 24 hours after surgery and remains higher than normal until 48 hours’,post-surgery. Furthermore, the transcutaneous absorption of IODINE is similar in the 0-2 and 2-14-year-old age groups, and the IODINE level following its transcutaneous absorption is excessive in both age groups.

Introduction: Studies have shown conflicting results regarding the skin absorption of IODINE from POVIDONE-IODINE solution (Betadine 7.5%) and its effects on the health of operating room personnel. Objective: This study aimed to measure the urinary IODINE concentration (UIC) among the operating room personnel of a hospital in Isfahan, Iran, after using POVIDONE-IODINE scrub (Betadine 7.5%). Materials and Methods: This descriptive-analytical study was conducted among operating room personnel of a selected hospital in Isfahan, Iran. Using a convenience sampling method, 100 participants were selected and divided into two groups: POVIDONE-IODINE scrub (n=50) and alcohol-based scrub (n=50). The scrubs were used for one week, three times per day, each for three minutes. One week after the study, morning urine samples were collected to measure the UIC using the Sandell-Kolthoff reaction method. The Shapiro-Wilk test assessed the normality of data distribution, and statistical comparisons between the two groups were conducted using the Mann-Whitney U test and chi-square test. Results: The mean age of the POVIDONE-IODINE scrub group and the alcohol-based scrub group were 31.9±6.29 and 31.7±5.59 years, respectively. Also, 94% in the POVIDONE-IODINE scrub group and 86% in the alcohol-based scrub group were female. No significant differences were observed between the two groups in age, work experience, gender, educational level, scrubbing frequency, or number of shifts per week. The results showed a significantly higher UIC in the POVIDONE-IODINE scrub group compared to the alcohol-based scrub group (290.0±0.73 vs 106.8±27.88 μg/L; P=0.001). Additionally, the prevalence of IODINE poisoning (>300 μg/L) was higher in the POVIDONE-IODINE group (8% vs 0%; P=0.001). Furthermore, in the POVIDONE-IODINE scrub group, the UIC was significantly higher in individuals with hand scrubbing frequency ≥10 per week compared to those with fewer frequency (316.3±54.20 vs 196.5±54.00 μg/L, P=0.001) and in those who worked ≥6 shifts per week (299.3± 66.9 vs 206.2±81.6 μg/L; P=0.011). Conclusion: This study suggests that hand scrubbing with POVIDONE-IODINE (Betadine 7.5%) can increase the UIC and the risk of IODINE poisoning in operating room personnel. Therefore, it is recommended to consider alternative solutions, such as alcohol-based solutions, for hand scrubbing in operating rooms.

Background and Purpose: Neonatal conjunctivitis which mostly occurs after birth, has a high prevalence rate according to the world statistics (0.4-18.9%). But its statistical value in our country is not known. Standard prevention methods are costly and not accessible.This disease can lead to corneal ulceration, blindness and infection.In this study, POVIDONE IODINE 2.5% was used for treatment of conjunctivitis regardless of its ethiology to determine, whether this drug which effectiveness and safety has already been proved in previous studies, could prevent or reduce neonatal conjunctivitis or not?Materials and Methods: 1130 neonates born in nursury of Razi hospital in Ghaemshahr were studied during 1997-98. The study was double blind in which Betadine drops 2.5% was used in one eye of the neonate immediately after birth and the other eye of the same neonate was treated as control. Then during two visits in two consecutive weeks, the positiveness of conjunctivitis was noted by visiting preformer.Results: The preventive effect of the drug was desirable during the first week of treatment because the eye which was not received the drug developed conjunctivitis 1037 times more than the eye which received the drug.But during the second week the difference was not significant in two eyes.Other important findings include, higher conjunctivitis rate in neonates born by normal delivery as compare to cesarean section (P<0.001). Conjunctivitis was more prevalent in boys as compare to girls during the first and second week (P<0.001). There was no significant difference between premature and full term and also between intact membrane and premature rupture of membrane.Conclusion: As regard to the low cost of the drug and its availability and also the positive effects of this drug during its use in first and second week of birth, its extensive use is recommended for prevention of neonatal conjunctivitis.

Scrubbing of surgical team is an important precaution for postoperative infections. It is performed to disinfect the hands, leading to secondary infection reduction of surgical wound. The procedure is done mechanically and chemically with scrub solutions such as POVIDONE IODINE, alcoholic disinfectants, chlorhexidine etc. In Iran, the routine solution of scrubbing is POVIDONE IODINE (Betadine). The Purpose of this clinical trial was to compare the disinfectant effects of Betadine with Decosept on the hands of surgical team in Loghman-e-Hakim teaching hospital affiliated to Shaheed Beheshti Medical University.Materials and Methods: 30 operating room (OR) staff and students were selected by convenient sampling method. Each subject scrubbed 2 times with 1-week interval, first with Betadine and second with Decosept. All members of a surgical team in an operation scrubbed with a similar method and solution. Samples were collected from the hands before and after scrubbing for the first scheduled operation through instructing the procedure (hand washing with soap and water, rinsing, complete drying, application 15 ml of one of the solutions in three stages [at each stage, 5 ml and 1-minute interval], rinsing and complete drying), placing the hands in culture media and sending the samples to laboratory in standard condition for recording.Results: Findings showed significant differences in the colonies of Gram-positive cocci, Gram-negative bacilli and fungi before and after scrubbing in each solution (P=0.0001). No positive case was found before and after the procedure with respect to Gram-negative cocci and Gram-positive bacilli. No significant difference was found between the effects of the 2 solutions before and after scrubbing.Conclusion: Both solutions were effective on disinfecting the hands of surgical team.