Benefits of Povidone-Iodine Solution in Colorectal Operations: Science or Legend

Pattana-arun, Jirawat; Wolff, Bruce G.

doi:10.1007/s10350-008-9213-8

Cited by 25 publications

(22 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This systematic review provides evidence that irrigation with PVI may reduce wound infection following elective colorectal operations. This finding is in disagreement with a recent narrative review [6]. The narrative review states that there is no conclusive evidence to support PVI; however, the authors did not perform a meta-analysis.…”

Section: Discussioncontrasting

confidence: 64%

“…The first article was removed because it was a narrative review on PVI in colorectal operations [6]. A second article was excluded due to lack of a control group, thus not meeting our criteria for a RCT [17].…”

Section: Resultsmentioning

confidence: 99%

“…PVI functions by releasing free iodine, which binds with protein [6]. Once bound, the iodine is carried across the cell membrane into the cytoplasm of cells by polyninylpyrrolidone [7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Povidone-Iodine Irrigation of Subcutaneous Tissues May Decrease Surgical Site Infections in Elective Colorectal Operations: A Systematic Review

et al. 2011

View full text Add to dashboard Cite

BackgroundPostoperative wound infection is the most common complication following abdominal surgery and leads to delayed wound healing, prolonged hospital length of stay (LOS), and causes morbidity. Povidone-Iodine (PVI) is a broad-spectrum anti-septic and disinfectant solution, and can be used intra-operatively to irrigate subcutaneous tissues prior to abdominal skin closure. We systematically reviewed the literature regarding the efficacy of intra-operative PVI irrigation of subcutaneous tissues following elective colorectal surgery.MethodsA comprehensive search of electronic databases and various grey literature sources was completed. Unpublished and non-English-language results were included. All clinical controlled trials involving PVI solution in adult colorectal surgery were included. Two independent reviewers assessed the studies for relevance, inclusion, methodological quality and extracted data from the full versions of the manuscripts. Disagreements were resolved by re-extraction or third party adjudication. Data for dichotomous outcomes are reported as relative risks (RR) with 95% confidence intervals (CI). For continuous data, mean differences (MD) are reported with 95% CIs.ResultsFive randomized controlled trials (RCTs) involving 205 patients comparing PVI solution or spray to a control group following abdominal fascial closure in elective colorectal or clean-contaminated operations were identified. Pooled results demonstrated a reduction in surgical site infection for patients treated with PVI (RR = 1.97; 95% CI: 1.22 to 3.17) compared to controls.ConclusionsIrrigation of subcutaneous tissues with PVI following abdominal fascial closure is associated with a reduced incidence of surgical site infection. Due to the small number of included trials and patients, additional robust randomized trials are needed.

show abstract

Section: Discussioncontrasting

confidence: 64%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Povidone-Iodine Irrigation of Subcutaneous Tissues May Decrease Surgical Site Infections in Elective Colorectal Operations: A Systematic Review

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Some Authors reported the utility of PVI in reducing the bacterial concentration in colon mucosa [7]. A recent review from the Mayo Clinic was sceptical about PVI usefulness in colon surgery, nevertheless the authors concluded that in the acute setting peritoneal or wound irrigation with PVI may be useful in dirty or contaminated operations [8]. It has been suggested that Sodium Hypochlorite is more active on E. coli than PVI [9], but its use should be avoided as it is associated with higher rate of complications [7-10].…”

Section: Discussionmentioning

confidence: 99%

Rectosigmoid stump washout as an alternative to permanent mucous fistula in patients undergoing subtotal colectomy for ulcerative colitis in emergency settings

et al. 2012

View full text Add to dashboard Cite

BackgroundRestorative proctocolectomy with ileopouch-anal anastomosis (IPAA) is the treatment of choice for intractable or complicated ulcerative colitis(UC). Elderly patients often present with acute colitis requiring emergent subtotal colectomy(SC). Frail patients are at risk of developing septic complications related to the closed rectosigmoidal stump, often requiring formation of a second stoma to be reversed at the time of completion proctectomy. This carries nuisance to such exhausted patients. We propose a simple and inexpensive trick to avoid the need for creating a mucous fistula.MethodsIPAA was performed as a 3-stage procedure in emergency settings. The rectosigmoidal stump was closed and placed subcutaneously; skin was closed over it. After SC, if patients showed signs of stump-related pelvic sepsis, a lavage of the rectal stump with povidone iodine solution and with saline was carried out as a rescue treatment aiming to avoid the need of opening the rectal stump to drain sepsis.ResultsThirty-five patients underwent SC for UC between 1987 and 2012. The skin was closed over the closed stump in the 20. Seven patients out of these 20 experienced early stump-related septic complication. In five cases, we were able to avoid opening of the rectal stump, and a second stoma was unnecessary. After opening the closed stump in the remaining ones, a prompt improving of symptoms was observed.ConclusionsRectal washout was well tolerated and avoided a second stoma in five out of seven patients, with better quality of life and body perception after IPAA surgery. This is relevant when dealing with geriatric patients, needing to completely recover before undergoing completion proctectomy.

show abstract

“…In addition, instillation of cytotoxic agents such as povidone-iodine into the colon lumen is performed to decrease local recurrence. While detection of exfoliated viable tumour cells in the peritoneal cavity and the colon lumen proximal and distal to the tumour is a known phenomenon, we are lacking strong clinical evidence for any preventive effect of the above-mentioned techniques in terms of reduction of local or distant recurrence [11][12][13][14]. What has been shown to have a strong impact on recurrence and long-term outcome is the experience of the surgeon and institution as could be demonstrated by the German Colorectal Study Group.…”

Section: Surgical Strategy and Technical Aspectsmentioning

confidence: 99%

Surgery of colon cancer (conventional open and laparoscopic surgery)

Spatz

Anthuber

2010

Eur Surg

View full text Add to dashboard Cite

Zusammenfassung. Grundlagen: Das Kolonkarzinom ist eine der häufigsten Todesursachen in der westlichen Hemisphäre mit ca. 639.000 krebsbezogenen Todesfällen pro Jahr weltweit. Die radikale chirurgische Tumorentfernung ist die entscheidende Behandlungsoption und stellt ein klassisches Betätigungsfeld des Allgemein-und Viszeralchirurgen dar.Methodik: Ziel der vorliegenden Arbeit war mit Hilfe einer Literatursuche in PubMed, DIMDI und EMBASE ergänzt durch eigene klinische Erfahrungen wichtige Arbeiten zur chirurgischen Therapie im Sinne einer aktuellen Ü bersichtsarbeit zusammenzufassen und dabei auch theoretische Grundlagen zu vermitteln.Ergebnisse: Tumorsitz und entsprechende Lymphabflusswege, Respektierung von anatomisch-embryonalen Schichten und arterielle Perfusion an den Absetzungsrändern bestimmen das Resektionsausmaß. Eine an diesen Prinzipien orientierte optimale chirurgische Technik ermöglicht eine niedrige Lokalrezidivrate und wirkt sich positiv auf das Langzeitergebnis aus. Die laparoskopische Technik ist dabei der offenen Technik ebenbü rtig. Auch in der Metastasenchirurgie ermöglicht die R0 Resektion ein Langzeitü berleben fü r ausgewählte Patienten. Durch multimodale Rehabilitation im Sinne eines perioperativen Fast Tack Managements lässt sich das chirurgische Trauma reduzieren und die Rekonvaleszenz beschleunigen.Schlussfolgerungen: Resektabilität und chirurgische Technik sind entscheidend für das Ü berleben von Patienten mit lokalisiertem oder bereits metastasiertem Kolonkarzinom.Schlüsselwörter: Kolonkarzinom, lymphogene Ausbreitung, chirurgische Technik, Ü berleben, perioperatives Management.Summary. Background: Colon cancer is a leading cause of death in western countries and accounts for 639,000 cancer-related deaths worldwide. Surgical tumour clearance is the key treatment option and represents a classic field of action for the general and visceral surgeon.Methods: PubMed, EMBASE and DIMDI were searched for articles referring to state of the art surgical management of colon cancer complemented by our own clinical experience to create an overview of up-todate treatment options and theoretical background knowledge.Results: The extent of bowel and mesenteric resection is dictated by the vascular supply and corresponding lymphatic drainage, careful attention to anatomical-embryological tissue planes and provision of adequate blood supply at the resection margins. Accordingly, optimal surgical clearance results in low local recurrence rates and translates into improved survival. In this context, the open and laparoscopic approaches yield similar results in terms of long-term outcome and oncological radicality. Radical resection of metastases results in long-term survival in selected patients. Fast Track rehabilitation facilitates attenuation of perioperative stress response and enhances recovery.Conclusion: Resectability and surgical technique are pivotal for long-term survival in all stages of colon cancer.

show abstract

Benefits of Povidone-Iodine Solution in Colorectal Operations: Science or Legend

Cited by 25 publications

References 71 publications

Povidone-Iodine Irrigation of Subcutaneous Tissues May Decrease Surgical Site Infections in Elective Colorectal Operations: A Systematic Review

Povidone-Iodine Irrigation of Subcutaneous Tissues May Decrease Surgical Site Infections in Elective Colorectal Operations: A Systematic Review

Rectosigmoid stump washout as an alternative to permanent mucous fistula in patients undergoing subtotal colectomy for ulcerative colitis in emergency settings

Surgery of colon cancer (conventional open and laparoscopic surgery)

Contact Info

Product

Resources

About