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  Dr. Joffe writes:    <  Let me quibble for a moment with the assertion that
iodine (as in
Betadine Solution) is toxic to tissues.  I have heard many surgeons express
this as fact, but it is not, to my knowledge, substantiated by the
literature.
A misreading of the studies I think has led to propagation of this myth....>
 
He is correct that there is a pucity of outcomes literature on the subject.
However, there _is_ surgical literature support for the notion that
Povidone-iodine 10% (PI)is tissue toxic, and perhaps affects outcomes.
-Viljanto (Arch Surg 115:253, March 1980) 5% PI caused increased wound
infection compared with controls (in appendectomy wounds), though 1% solution
found a lower infection trate than controls. In vivo cell analysis found
impaired fibroblast migration and leukocyte toxicity of the 5% solution.
-Lineaweaver (Arch Surg 120(3):267, March 1985)found even 1% PI to be
cytotoxic, and in their animal wound model, weaker wounds 4 days after
wounding.
 
It is true there are other studies demonstrating reductions in wound
infection rates when PI is used. The verdict is not yet in. I cleanse around
(more superficial) wounds with 10% PI, trying not to get the betadine in the
wound. I sometimes use 1% PI to irrigate deeper wounds.
 
Jeremy Golding, MD
 
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html