Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Betadine: to use or not to use?

Discussion in 'Australia' started by Kara47, Dec 14, 2012.

  1. Kara47

    Kara47 Active Member


    Members do not see these Ads. Sign Up.
    Hello all,
    I've had a few nurses/ AINs tell me in the past few weeks that they were instructed to not use Betadine at all anymore. Nobody can give me a definitive answer why.
    Has anyone heard of this outside the Aged Care industry?
    I thought it was obligatory to cover you in the stuff during pre -op in any hospital, so if this becomes the latest fad, what will they use then? :)
    Nobody has suggested what you use as an alternative either.
    Is this political correctness gone mad ( again!) or this there any evidence to back it up?
    Cheers,
    Kara
     
  2. Rob Kidd

    Rob Kidd Well-Known Member

    Well, as I understand it from ~10-20 years ago diabetic meetings, betadine is cytotoxic, delays healing, does nothing good, only harm. To put it another way, they either need systemic antibiotics, or nothing. Am I wrong? My bed partner is an expert in this area, I await to be shot down..............
     
  3. blinda

    blinda MVP

    Hi Kara and Rob,

    As a student, I was advised that as a result of "increased allergy to iodine" we should not be using Betadine, or any other skin prep containing iodine. I thought it odd at the time, because iodine is essential for the endocrine system. Should have questioned it at the time, but I was shy and retiring then....

    One of my favourite derm sites confirms my thoughts. Taken from; http://www.dermnetnz.org/treatments/iodine.html;
    This review also agrees that the term `iodine allergy` is misleading; http://www.australianprescriber.com/magazine/32/5/125/8/

    Interesting quote from the above link;
    So, it would appear that the more common side effects sometimes seen with Betadine (urticara, etc - NOT true allergy) are probably caused by either, or both, the povidone or PVP`s added to the antiseptic.

    Anyway, as I have a handful of pts who report `allergy to iodine` and more than a few with hyperthyroidism and other thyroid disorders, I decided to look at alternative skin preps for nail surgery and VP tx and found this; http://www.ncbi.nlm.nih.gov/pubmed/19796594?dopt=Abstract

    So, for those pts I use Chlorex and 70% IPA....and its less messy than iodine solutions, IMO.


    Cheers,
    Bel
     
  4. Admin2

    Admin2 Administrator Staff Member

  5. Cameron

    Cameron Well-Known Member

    Kara47

    Bob and Belinda are quite right. As far as I understood the concerns re betadine 20 years ago meant health professionals should not proceed with betadine products on large ulcerated areas. Small cuts and abrasions were perfectly safe. Again to the best of my knowledge Diabetes Australia currently recommend betadine products for first aid to their members. I have put the word out to see what more technically informed colleagues have to say.

    toeslayer
     
  6. Tully

    Tully Active Member

    When working in aged care in NZ last year,
    I was told by an RN that there had been 1 paper- which she could not name and I could not find- which states Betadine is of limited efficacy generally (yes, I am aware it is CI in ulcers etc), so the NZ Government Health system were no longer using or recommending its use.

    I am happy to be corrected by anyone with more info!

    :santa:
     
  7. kitos

    kitos Active Member

    Just come across this thread and then double checked the DLT catalogue as 10% Betadine is/was used in trials (Durham School 2002) of EZ Swab to rinse out the area post phenolisation. Before I read that I had wiped any excess out with a sterile swab and if excess had collected in the proximal fold then sprayed with Chlor hex and then swabbed out.

    According to this then should I be doing that? I alwys check to see if any Iodiune allergy is present but most have already presented with paronychia and have had Inadine anyway.

    Nick

    Thoughts please anyone?
     
  8. blinda

    blinda MVP

    Hi Nick,

    I doubt very much whether Betadine would be any more of a sensitizer or cytotoxic than IPA, which is often used to `flush`.

    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=45852&highlight=flush

    Personally, I don`t flush with anything as phenol is self-limiting.

    Cheers,
    Bel
     
  9. kitos

    kitos Active Member

    Hi Bel,

    Thanks for that. It was only after I read that in the DLT catalogue that I started doing so. Interestingly although never quantifiable I have had a couple of very partial re growths on TNA's since doing this which I hadn't had before. Unable to prove/disprove anything but I think I'll go back to the old method and no flushing.

    With Betadine that is ;)

    Best wishes

    Nick
     
  10. blinda

    blinda MVP

    Yeah, I was a little suprised to see they used Betadine post op in their study. But like I say, no more harmful than Chlorex, alcohol, etc I spose. None of which can`dilute` or `neutralise` phenol, which was pointed out in the link I provided previously, so unlikely to be the cause of any regrowth, IMO. Certainly can`t be any more cytotoxic than the phenol itself.
     
  11. dsfeet

    dsfeet Active Member

    There was a paper written on the cyotoxic properties of Betadine on ulcers, can't remember the name of it , but it was written by susan Lauric , who at the time worked at CSU Uni. Maybe this is the paper Tully referred too.
    From memory ( which is maybe not reliable) it was not to do with preop skin pre, but as a treatment for cuts and ulcers.
    one comment read also on this site was that it was ok for small wounds and still not for ulcer use. Think this was an opinion not a paper. !!!
     
  12. kitos

    kitos Active Member

    Thanks Bel

    Ahhh well we live and learn and isn't that what life and experience is all about?

    Take care

    Nick
     
  13. bmjones1234

    bmjones1234 Active Member

    Hi there guys,

    Well I am currently a 4th year at QMU, out research product is to be the effectiveness of a Povidone-Iodine based solution. Without going into to much detail at this time, what is worth mentioning is that the literature search for Betadine and basically any Iodine based was very interesting and relevant.

    Its use in todays surgical procedures is larger because of historic acceptable, the actual data testing the Iodine has only recently started to be retested, pretty important considering it has been used for about 150 years I read in one journal.

    What is really interesting is that the crux of the effectiveness is not just the concentration, but what it is combined with. For example Alcohol is by far more effective, but is short acting and so needs reapplication, but this can dry out the skin/wound very quickly. Iodine is longer acting but takes ages to dry (compare with alcohol). Yet when iodine is combine with an alcohol solution it dries very quick and is very effective in destroying bacteria.

    As to how much of this effectiveness is down to the iodine itself though is very questionable as it is usually with a higher percentage of alcohol. The general pattern that appears to be emerging from the literature that I have seen is that iodine is not that brilliant at would cleansing at all, it might still be useful in a hand scrub for surgery but there is a strong case to be made that we accept it as true because we have done it for so long. Now we have the actual capacity to test whether as substance it really is working.

    I will try to obtain some literature in the future to pass on after I have complete my project that might shed some more light on the subject.

    B
     
  14. podesh

    podesh Active Member

    Hello

    No on ulcers, yes on superficial stuff. I use Inadine on hypergran tissue, as tends to shrink it fast.

    Christmas hols soon!! :)

    Esher
    x
     
  15. lisacm2

    lisacm2 Welcome New Poster

    I was told in a wound care course not to use anymore on open wounds (the toxicity thwarts the healing - kills the new cells and damages old ones) - not sure about as an antiseptic before procedures though!
     
  16. DTT

    DTT Well-Known Member

    There would appear to be a problem in the UK with Betadine dry powder spray. It is becoming increasingly difficult to obtain and I am being told by suppliers " there is a problem with manufacture" but none can tell me what the problem is or if / when it is likely to be resolved.

    The savlon dry powder spray is still available but it is a weaker version of betadine and I have not found it particularly effective.

    Can anyone spread more light on the manufacturing problem ?
    Cheers
    D;)
     
Loading...

Share This Page