Effect of Intrapleural Povidone-Iodine Lavage on Thyroid Hormones in Thoracic Surgery

Fındık, Göktürk; Gezer, Suat; Aydoğdu, Koray; Öz, Gökşen; Küçükbayrak, Abdulkadir; Taştepe, İrfan; Karaoğlanoğlu, Nurettin; Kaya, Serkan

doi:10.1055/s-0029-1240920

Cited by 7 publications

(4 citation statements)

References 12 publications

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“…showed that abdomens washed with 2% PI did not cause significant changes in TSH, thyroxine T3 and T4. Other studies have shown that pleural cavity irrigation, mediastinal irrigation, and iodine‐coated internal fixators do not cause thyroid dysfunction 24,25 . In addition, PI is considered to be a weak allergen, with its allergy incidence rate at only 0.4% 26 …”

Section: Discussionmentioning

confidence: 99%

“…Other studies have shown that pleural cavity irrigation, mediastinal irrigation, and iodine-coated internal fixators do not cause thyroid dysfunction. 24,25 In addition, PI is considered to be a weak allergen, with its allergy incidence rate at only 0.4%. 26 In orthopedic clinical work, PI solution or PI diluted in normal saline are often used to irrigate the incision, which has been shown to have a good effect on preventing infection.…”

Section: Surgical Infection and Pi Irrigationmentioning

confidence: 99%

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The Toxicity and Antibacterial Effects of Povidone‐Iodine Irrigation in Fracture Surgery

Wang

Huang

et al. 2022

Orthopaedic Surgery

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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‐β1) 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‐β1, IL‐10, in addition, decrease IL‐6. 5% PI irrigation would inhibit tissue healing, and increase IL‐6, decrease BMP‐2, VEGF, TGF‐β1, 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.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Infection and Pi Irrigationmentioning

confidence: 99%

The Toxicity and Antibacterial Effects of Povidone‐Iodine Irrigation in Fracture Surgery

Wang

Huang

et al. 2022

Orthopaedic Surgery

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“…The washing operation has been repeated twice. At selected intervals (1,2,4,6,8,12,20 and 24 h) 1.5 ml of the dermal bathing solution was removed and collected for the analyses. Each receptor sample was immediately replaced with an equal volume of fresh made physiological solution.…”

Section: The Experimentsmentioning

confidence: 99%

“…In patients where the burned injury spread over 25% of the skin surface with deep second-and third-degree burns, the serum total iodine levels have been reported to markedly increase to 4500-48,000 mcg/dl and possible systemic complications due to elevated free iodine levels have been reported (Aiba et al, 1999). The amount of absorption is higher in cases of skin damage or the presence of thinner skin, therefore this effect was noted in infants (Erdogan et al, 2013;Findik et al, 2010). In animal experiments, transcutaneous absorption of PI through healthy skin has also been examined using radioisotope I125 (Furudate et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Povidone iodine skin absorption: An ex-vivo study

et al. 2015

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Povidone iodine is a water-soluble complex used to disinfect the skin surface and it exerts prolonged germicidal action against a broad spectrum of germs. Indeed, it is often applied on burned skin, large wounds, deep tissues or mucosa. Notably some surgical hand-scrub solutions, which are considered safe antiseptics, contain large amounts of iodine that can be absorbed by skin. The aim of present study was to study the skin absorption of iodine after the application on the skin of povidone-iodine solution, used by health care workers during surgical procedure. We use Franz diffusion static cells with human skin. After 24h from the beginning of our measurement the iodine concentration in the receiving compartment was 11.59±6.3μg/cm(2). The medium flux calculated was 0.73±0.33μg/cm(2)/h with a lag time of 8.9±1.5h. These in vitro results confirmed that povidone iodine could pass through the skin in a relevant amount that can explain the clinical findings in burned or surgically treated patients. In professional use the repetitive contact with povidone iodine, also as soap, can cause iodine skin permeation that must be considered when the washing procedures are repeated more than 20 times a day

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Oral transmucosal absorption of iodine after intraoral preparation with povidone-iodine prior to oral surgeries: a randomized controlled study in 12 male patients

et al. 2021

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Effect of Intrapleural Povidone-Iodine Lavage on Thyroid Hormones in Thoracic Surgery

Abstract: The scores show that the iodine absorbed by the pleura during intraoperative povidone-iodine lavage has an effect on thyroid function. Intrapleural PI lavage results in changes to some thyroid hormone levels due to pleural absorption. Thus, intrapleural PI lavage should be used with care.

Cited by 7 publications

References 12 publications

The Toxicity and Antibacterial Effects of Povidone‐Iodine Irrigation in Fracture Surgery

The Toxicity and Antibacterial Effects of Povidone‐Iodine Irrigation in Fracture Surgery

Povidone iodine skin absorption: An ex-vivo study

Oral transmucosal absorption of iodine after intraoral preparation with povidone-iodine prior to oral surgeries: a randomized controlled study in 12 male patients

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