An algorithm for treatment of a patient with an infected wound using povidone-iodine in the outpatient setting
https://doi.org/10.21518/1995-1477-2018-3-4-51-56
Abstract
The high prevalence of skin and soft tissue infections (SSTI) urges healthcare professionals to improve the traditional (operative and pharmacological) methods of their treatment, and to find new methods that are applicable in outpatient practice, which can reduce the period of disability and reduce the number of complications. The choice of the right drug for such infections to influence the local infectious process is one of the most important objectives of the local wound therapy. The paper presents data on the effectiveness of Povidone-Iodine (Betadine) for external use with a broad spectrum of action, intended for the treatment of SSTI, including abscesses, furuncles, carbuncles, infected traumatic lesions of the skin and trophic ulcers in Phases 1 to 2 of the wound process. The drug has a pronounced combined effect: antimicrobial (bactericidal, bacteriostatic), wound healing, regenerating, local anesthetic and protective. This brings us to the conclusion about the advantages of Betadine and provide a rationale for its use to treat surgical infections of the skin and soft tissues in the outpatient setting.
About the Authors
N. N. LebedevRussian Federation
Moscow
V. Е. Rozanov
Russian Federation
Moscow
A. N. Shikhmetov
Russian Federation
Moscow
References
1. Blatun LA. Local drug treatment of wounds. Khirurgiya im. N. I. Pirogova, 2011, 4: 51–59.
2. Golub AV, Privolnev VV. Local antibacterial therapy of surgical infections of the skin and soft tissues in the outpatient settings: components of success. Rany i Ranevye Infektsii, 2014, 1 (1): 33–38.
3. Devyatov VA, Pribb AN, Kozlov AV, et al. Ways to improve outpatient care for patients with surgical infection. Khirurgia, 1993, 4: 79–84.
4. Surgical infections of skin and soft tissues. Russian national guidelines. M.: Borges, 2009. 89 p.
5. Ershov AK. The use of Betadine in surgical practice. RMJ, 2011, 16: 999–1001.
6. Kozlov RS, Golub AV. Antimicrobial therapy strategy as an attempt of antibiotic renaissance. Klin. Microbiol. Antimicrob. Khimioter, 2011, 13: 322–334.
7. Kudryavtseva AV, Fluer FS, Maksimushkin AYu. Options for eradication of Staphylococcus aureus in complicated atopic dermatitis in children. Rossiyskiy Vestnik Perinatologii i Pediatrii, 2012, 6: 32–36.
8. Kuzin MI, Kostyuchenok BM, Kolker II, et al. Anaerobic non-clostridial infection in surgery (methodical guidelines). M., 1987, p. 29.
9. Privolnev VV. The choice of drug for the local treatment of infected wounds. Rany i Ranevaya Infektsiya. Zhurnal Im. Prof. B. M.Kostyuchenka, 2015, 2 (1): 13–18.
10. Privolnev VV, Karakulina EV. Local treatment of wounds and wound infections. Klin. Mikrobiol. Antimikrob. Khimioter., 2011, 13: 214–222.
11. Privolnev VV, Zubareva NA, Karakulina EV. Topical treatment of wound infection: antiseptics or antibiotics? Klin. Mikrobiol. Antimikrob. Terap. 2017, 19 (2): 131–138.
12. Drury B, Scott J, Rosi-Marshall EJ, Kelly JJ. Triclosan exposure increases triclosan resistance and influences taxonomic composition of benthic bacterial communities. Environ Sci Technol, 2013, 47: 8923–8930.
13. Geissler A, Gerbeaux P, Granier I et al. Rational use of antibiotics in the intensive care unit: impact on microbial resistance and costs. Intensive Care Med, 2003, 29 (1): 49–54.
14. Johannessen M, Sollid JE, Hanssen A-M. Host and microbe determinants that may influence the success of S. aureuscolonization. Front Cell Infect Microbiol, 2012, 2: 56.
15. Mikhalsky VV, Goryunov SV, Bogdanov AE, et al. Use of Betadine in the treatment of infected wounds. RMJ, 2010, 28 (18): 1–4.
16. Rodin AV, Privolnev VV, Savkin VA. The use of povidone-iodine for the treatment and prevention of wound infections in the surgery practice. Statsionarozameschayuschie Tekhnologii: Ambulatornaya Khirurgiya, 2017, 3–4: 34–51.
17. Sokolova TV, Malyarchuk AP. Universal antiseptic in the treatment of primary and secondary pyoderma. Klin Dermatol i Venerol, 2010, 6: 83–88.
18. Adem P, Montgomery C, Husain A et al. Staphylococcus aureus Sepsis and the Water-house Friderichsen Syndrome in Children. The New England Journal of Medicine, 2005, 22: 1245–1250.
19. BigLiardi PL, ALsagoff SAL, EL-Kafrawi HY, Pyon JK, Wa CTC, Villa MA. Povidone iodine in wound healing: A review of current concepts and practices. Int J Surg, 2017, 44: 260–268.
20. Blatun LA. Modern iodophors: effective drugs for the prevention and treatment of infectious complications. Khirurgia. Cons Med. Prilogenie, 2005, 7 (1): 83–90.
21. Chekmareva IA, Blatun LA, Terekhova RP, Zakharova OA, Kochergina EV, Agafonov VA. Morphofunctional aspects of wound regeneration using iodine-containing ointments. Khirurgia, 2014, 1: 54–58.
22. Star RV, Zurawski J, Ismail M. Preoperative vaginal preparation with povidone – iodine and risk of postcesarean endometritis. Obstet Gynecol, 2005, 105 (5): 1024–9.
23. Voboril R, Weberova J, Kralove H. Successful treatment of vascular prosthetic grafts in the groin using conservative therapy with povidone-iodine solution. Ann Vasc Surg, 2004, 18 (3): 372–375.
24. Tikhomirov AL, Sarsania SI, Tuskayev KS. Topicality of the use of povidone-iodine in the obstetrician-gynecologist practice. RMJ. Akusherstvo, Ginekologia, 2014, 1: 11–13
25. Leeder PC, Matthews T, Krzeminska K, Dehn TC. Routine day-case laparoscopic cholecystectomy. Br J Surg, 2004, 91 (3): 312–316.
26. Tan KY, Ramesh HS, Sanoff HK et al. Colorectal surgery in octogenarian patients-outcomes and predictors of morbidity. In J Colorectal Dis, 2009, 24 (2): 185–189.
27. Microbial identification and antibiotic sensitivity testing. Methodologic Guidelines MU 4.2.1890–04 of 04.03.2004.
28. Technique of collecting and transporting biomaterials in microbiological laboratories. MU 4.2.2039–05 of December 23, 2005.
29. Clinical Microbiology Procedures Handbook. Garcia L. S., editor. 3rd Ed. ASM Press, Washington, D. C., 2010.
30. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters, 2012. URL:www.eucast.org/clinical_breakpoints.
31. Razmahnin EV, Shangin VA, Kudryavtseva OG, Okhlopkov DYu. Possibilities of vacuum instillation therapy using Dimexide and Betadine in the treatment of purulent wounds. Acta Biomedica Scientifica, 2017, 2 (6): 153–156.
32. Kuzin MI, Kostyuchenok BM. Wounds and wound infection. M.: Medicine, 1990. 592 p.
33. Krasner D. Wound care: how to use the Red-Yellow-Black system. Am J Nursing, 1995, 95 (5): 44–47
Review
For citations:
Lebedev N.N., Rozanov V.Е., Shikhmetov A.N. An algorithm for treatment of a patient with an infected wound using povidone-iodine in the outpatient setting. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2018;(3-4):51-56. (In Russ.) https://doi.org/10.21518/1995-1477-2018-3-4-51-56

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.