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Just wondering everyone's thoughts on using Betadine on diabetic ulcers??
Whats the good and the bad on the situation??

 

Hi Lauren84 I know Helen Banwell from the University of South Australia did some work a few years ago in this area and it was a great literature review behind it.

See if you can get hold of it - i'm sure its floating around cyberspace somewhere online. Although it was some years back it may be a great place to start!

 

Hi Lauren84,
My understanding is that Povidone iodine is no longer advocated in the use of chronic wounds as it's cytotoxic to the fibroblasts (along with other forms of antiseptics as well). cadexomer iodine, albeit expensive, is much better to use on chronic wounds.
Hope this helps,
Stuart

 

my understanding aswell. Have head theat it might be advisable to apply PI then flush with NaCl.

 

You might search author Bill Lineweaver,md (I think in one of the plastic sx journals) who I worked with in SF, Ca many years ago. He did some work that--in my recollection- basically showed that betadine was effective in wounds as an antimicrobial and had minimal cytotoxic effects at something like a 1:10000 dilution.

 

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Hi Lauren84,

Paul is correct, Helen did a sytematic review a few years ago. the link is below.
http://www.unisa.edu.au/cahe/resint/systematic_revs/CAHE SR PVP-I open wounds Helen Banwell.pdf

cheers

Ryan

 

Povidine Iodine is great for killing bacteria and viruses, excellent first line tx for wounds, esp where dirt is involved (grazes and such) but I agree it's counteractive in healing. Something like honey (medical grade) is very good for both cleaning and healing ulcers- as long as pt is not allergic. Hope that helps :)

 

Thanks Ryan - that's the one I was looking for...great review and definitely worth a read even though its a few years old now.

 

Correct, dilute Betadine was equally bacteriocidal but not cytotoxic. The dilution was 0.5% which is diluted 20x from the standard concentration of 10% povidone iodine.

That being said, Betadine is an astringent and shouldn't be used routinely. I use it in cases where there is infection and I'm taking the patient to the OR anyway, or in cases where there is a lot of drainage and I would like some drying.

 

Robyn Hood
In public hospitals in Qld, Betadine was not available as a long term wound care product, but widely used as a preoperative"scrub" for patients and operators. It has a short "maximal kill" time and not indicated when promotion of healing is required. It's main advantage was effectiveness in the presence of blood and dirt. It is also sold in pharmacies as a gargle for infected throats - how delicate does that get???
I ask "what is the effect at low dilution over time on the potential to create resistence in wound flora ?"
Perhaps we should investigate the veterinarian's research- they seem to have a handle on these problems and cannot afford to lose valuable breed stock...
Robyn Hood:pigs: