Several iodine formulations have been used for wound care for ages, but still there exist a number of controversial issues regarding their uses in the present era. Many published studies are available for both povidone iodine (PI) and cadexomer iodine (CI) with conflicting outcomes due to different preparations used and different study types. PI has a broad spectrum of activity including antiseptic properties, anti-inflammatory properties, low cytotoxicity, and good tolerability with the absence of associated resistance. CI is an immobilized iodine molecule in a hydrophilic modified-starch polymer bead with the dual property of cleansing the wound by absorbing the exudate and bactericidal effect by sustained release of iodine molecules over the infected wound. The preparations comprising PI and CI improve wound healing and minimize the bacterial infestation or contamination in various chronic wounds, burns, and ulcers. This review narrates the comparison of CI and PI for the management of wounds in the context of biofilm reduction, wound size reduction, and granulation tissue promotion.

BackgroundIn this era of upcoming newer formulations of topical ointments in the market, selecting an appropriate topical ointment for managing ulcers is challenging with regards to granulation tissue promotion, ulcer size reduction, and decrease in the amount of discharge from the ulcer. This study compares the outcomes of two topical iodine formulations, namely, cadexomer iodine ointment (0.9%) and povidone-iodine ointment (5%), for the management of various types of ulcers. MethodologyThis prospective, interventional study was conducted in a tertiary care hospital. After screening, 40 patients with ulcers (venous, arterial, diabetic, traumatic, infective) were subjected to simple randomization based on computer-generated random numbers at a ratio of 1:1 for the application of cadexomer (n = 20) (Group A) and povidone-iodine ointment (n = 20) (Group B). Selected patients were subjected to broad-spectrum antibiotics on admission and then shifted to special antibiotics based on the culture and sensitivity report of the wound. The application of these two formulations was done in three settings, each lasting 48 hours. The efficacy of these two formulations was assessed based on the following three parameters: (a) the percentage of granulation tissue promotion, (b) wound size reduction, and (c) decline in wound discharge. The study groups were compared using an unpaired t-test, while the association among the study groups was performed using Fishers' test, Student's t-test, and chi-square test. P-values less than 0.05 were considered significant. ResultsSignificant improvement (p < 0.05) in granulation tissue was observed with cadexomer ointment application compared to povidone-iodine ointment. Statistically significant reductions in ulcer size and discharge from ulcers were seen in both groups; however, clinically, cadexomer ointment was found to be more effective compared to povidone-iodine ointment in reducing ulcer size as well as in reducing the amount of discharge from ulcers. ConclusionsCadexomer iodine ointment proved to be better than povidone-iodine ointment in the management of ulcers regarding the percentage of granulation tissue promotion, ulcer size reduction, and decrease in the amount of discharge from ulcers.