PMID- 35913384
OWN - NLM
STAT- MEDLINE
DCOM- 20220920
LR  - 20220930
IS  - 1757-7861 (Electronic)
IS  - 1757-7853 (Print)
IS  - 1757-7853 (Linking)
VI  - 14
IP  - 9
DP  - 2022 Sep
TI  - The Toxicity and Antibacterial Effects of Povidone-Iodine Irrigation in Fracture 
      Surgery.
PG  - 2286-2297
LID - 10.1111/os.13422 [doi]
AB  - OBJECTIVE: Surgical site infection is a common complication of surgery, 
      especially in orthopedics. Povidone-Iodine (PI) is one of the oldest and most 
      commonly used disinfectants in surgery. However, the toxicity and antimicrobial 
      effect of PI have not been discussed. In addition, no study has explored the 
      optimum PI concentration for sterilization and tissue healing. This study 
      explores the germicidal efficacy of different concentrations PI, in addition, the 
      toxicity and antibacterial effects of PI irrigation in fracture surgery are also 
      discussed. METHODS: Methicillin-resistant Staphylococcus aureus and Pseudomonas 
      aeruginosa (P. aeruginosa) were used to evaluate the germicidal efficacy of PI in 
      vitro and in vivo. In vitro, the effects of PI on bacterial growth were analyzed. 
      2.5%, 1.25%, 0.5%, 0.25%, 0.05%, 0.025%, 0.005%, 0.0025% and 0% PI was added into 
      the bacterial suspension, besides, the bacterial algebra and growth rate were 
      tested. Meanwhile, the fluorescence intensity of viable bacteria was also tested 
      to evaluate the effects of PI on bacterial survival. In vivo, first, femoral 
      fracture with wound infection rat models were established. Second, thyroid gland 
      sections, blood thyroxine, urinary iodine, wound local skin, muscle and bone 
      tissue sections, serum creatinine and alanine aminotransferase, serum and bone 
      local tissue interleukin-6 (IL-6), interleukin-10 (IL-10), bone morphogenetic 
      protein (BMP-2), vascular endothelial growth factor (VEGF) and transforming 
      growth factor (TGF-beta1) were detected in rat femoral shaft fracture model with 5%, 
      2.5%, 0.5%, 0.05%, and 0% PI irrigation. Third, tissue bacteria culture was 
      tested in rat femoral fracture with wound infection model with different 
      concentrations PI irrigation. RESULTS: In vitro, 2.5%, 1.25%, 0.5% PI inhibited 
      the growth of bacteria. 1.25%, 0.5% PI killed all the bacteria, while 0.25%, 
      0.05% PI had not killed bacteria after about 10 min. The iodine absorption of 5%, 
      2.5%, 0.5% PI irrigation did not cause thyroid injury. The 5%, 2.5%, 0.5% PI 
      irrigation did not make serum creatinine and alanine aminotransferase abnormal 
      and can remove bacteria from wounds. The 0.5%, 2.5% PI irrigation can promote 
      tissue healing and increase BMP-2, VEGF, TGF-beta1, IL-10, in addition, decrease 
      IL-6. 5% PI irrigation would inhibit tissue healing, and increase IL-6, decrease 
      BMP-2, VEGF, TGF-beta1, IL-10. CONCLUSIONS: Povidone-Iodine was a widely used 
      disinfectant and 2.5%, 1.25% and 0.5% PI could effectively kill bacteria. Five 
      percent and lower concentration PI irrigation was safe and could not cause 
      thyroid, kidney and liver damage. The 0.5% PI irrigation was beneficial for 
      tissue healing but 5% PI irrigation was the opposite.
CI  - (c) 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John 
      Wiley & Sons Australia, Ltd.
FAU - Wang, Dong
AU  - Wang D
AUID- ORCID: 0000-0002-6107-7023
AD  - Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical 
      University, Beijing, China.
FAU - Huang, Xinli
AU  - Huang X
AD  - Department of Pathophysiology, Hebei Medical University, Shijiazhuang, China.
FAU - Lv, Wenrui
AU  - Lv W
AD  - Department of Respiratory and Critical Care Medicine, Beijing Chaoyang hospital, 
      Capital Medical University, Beijing, China.
FAU - Zhou, Junlin
AU  - Zhou J
AUID- ORCID: 0000-0003-4194-9012
AD  - Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical 
      University, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20220801
PL  - Australia
TA  - Orthop Surg
JT  - Orthopaedic surgery
JID - 101501666
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Infective Agents, Local)
RN  - 0 (Disinfectants)
RN  - 0 (Interleukin-6)
RN  - 0 (Transforming Growth Factor beta1)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 130068-27-8 (Interleukin-10)
RN  - 85H0HZU99M (Povidone-Iodine)
RN  - 9679TC07X4 (Iodine)
RN  - AYI8EX34EU (Creatinine)
RN  - EC 2.6.1.2 (Alanine Transaminase)
RN  - Q51BO43MG4 (Thyroxine)
SB  - IM
MH  - Alanine Transaminase/pharmacology
MH  - Animals
MH  - Anti-Bacterial Agents/pharmacology
MH  - *Anti-Infective Agents, Local/pharmacology
MH  - Creatinine/pharmacology
MH  - *Disinfectants/pharmacology
MH  - *Femoral Fractures
MH  - Interleukin-10/pharmacology
MH  - Interleukin-6
MH  - *Iodine/pharmacology
MH  - *Methicillin-Resistant Staphylococcus aureus
MH  - Povidone-Iodine/pharmacology
MH  - Rats
MH  - Surgical Wound Infection/microbiology/prevention & control
MH  - Therapeutic Irrigation
MH  - Thyroxine
MH  - Transforming Growth Factor beta1
MH  - Vascular Endothelial Growth Factor A
PMC - PMC9483079
OTO - NOTNLM
OT  - Antibacterial properties
OT  - MRSA
OT  - Povidone-iodine irrigation
OT  - Pseudomonas aeruginosa
OT  - Toxicity of povidone-iodine
EDAT- 2022/08/02 06:00
MHDA- 2022/09/21 06:00
PMCR- 2022/08/01
CRDT- 2022/08/01 09:56
PHST- 2022/06/22 00:00 [revised]
PHST- 2021/03/15 00:00 [received]
PHST- 2022/06/26 00:00 [accepted]
PHST- 2022/08/02 06:00 [pubmed]
PHST- 2022/09/21 06:00 [medline]
PHST- 2022/08/01 09:56 [entrez]
PHST- 2022/08/01 00:00 [pmc-release]
AID - OS13422 [pii]
AID - 10.1111/os.13422 [doi]
PST - ppublish
SO  - Orthop Surg. 2022 Sep;14(9):2286-2297. doi: 10.1111/os.13422. Epub 2022 Aug 1.