The Efficacy of Povidone-Iodine (PVI) in Reducing The Rate of

Infection in Wound Healing and Surgery Site Infection (SSI): A

Systematic Review of Randomized Clinical Trial
Yong Yee Wen

INTRODUCTION RESULTS
Wound healing is the complex biological process of
Year of Study Study
replacing the destroyed or damaged tissue by newly Author Conclusion
Study Design Population
produced tissue. Wound healing can face challenges
and be impaired as a result of infection or heavy 331 eligible pregnant women
Out of 311 women who were randomized into 2 treatment groups
(Chlorhexidine-Alcohol and Povidone-Iodine), the rate of SSI in the
Randomized who undergo elective or
bacterial burden. Staphylococci and streptococci are Luwang et al. 2021
Clinical Trial emergency cesarean delivery
Chlorhexidine-Alcohol group is 5.4% and that of the Povidone-Iodine
group is 8.6%. Therefore, those who received Povidone-Iodine as skin
(CD)
the most common encountered pathogenic organisms antiseptic had bigger chance of developing Surgical Site Infection (SSI).

in community-acquired superficial wounds. Wound
infection is associated with systemic illness, deep
Kambara et al. 2019
invasion, or cellulitis which required empirical systemic
antibiotic treatment. If the infection cause the direct
Randomized
498 patients undergoing elective
abdominal surgery at Toyohashi
Clinical Trial
Municipal Hospital, Japan
Out of 498 patients who were randomized into 2 types of sterilization
groups (Povidone-Iodine applicator and conventional steriization),
wound infection was detected in 16 patients (6.7%) in the Povidone-Iodine
applicator group and 16 patients (6.5%) in conventional sterilization
group. Therefore, Povidone-Iodine applicator is similar to conventional
sterilization, but can be considered because it is more convenient, safer,
and more economical.

inoculation of bone, osteomyelitis may developed and Out of 14 patients who were randomized into 2 treatment groups (PVP-
ILH and 10% Povidone-Iodine ointment), Povidine-Iodine ointment
require specialist intervention and management. Vogt et al. 2017
Randomized 14 patients with infected meshed
showed excellent antibacterial efficacy with no detectable
Clinical Trial skin grafts (MSGs)
microorganisms by Day 10 and has a strong and faster role in managing
Therefore, it is very important to prevent the risk of infected wound.

infection during a wound healing. Povidone-Iodine

Out of 100 patients who were randomized into 2 preoperative skin
(PVI) has been used as the prevention of wound Randomized
100 patients who were cleansing (2.5% Chlorhexidine-Alcohol and 10% Povidine-Iodine aqueous),
John et al. 2018 undergoing for clean 2.5% Chlorhexidine signifincantly reduced the risk of posoperative SSIs
Clinical Trial
infection for a long time due to its bactericidal ability contaminated elective surgeries and colonization of bacteria in elective surgeries when compared to 10%
Povidone-Iodine.
against a large array of pathogens. However, the
180 pregnant women who Out of 180 women who were randomized into 3 groups of vaginal
efficacy of this agent in reducing the rate of infection Randomized applied to gynecology cleansing (saline solution, Povidone-Iodine, and control), the amount of
Kanza et al. 2021
Clinical Trial outpatient clinic of a private C-reactive protein in patients who received Povidone-Iodine vaginal
have been debated. hospital for childbirth cleansing were higher than those who received saline vaginal cleansing.

Out of 90 patients who were randomized into 2 groups (incision wound

flushed by 5% Povidone-Iodine solution and 0.9% normal saline solution),
90 patients who were
Randomized surgical site infections were seen in 16 of 180 (12.5%) patients, 9 in
OBJECTIVE HG et al. 2018
Clinical Trial
undergoing elective
laparotomies
Povidone-Iodine and 7 in normal saline groups. Therefore, the infection
rate in patients who received Povidone-Iodine has increased infections
rates.

To determine the efficacy of Povidone-Iodine in 200 patients who were

Out of 200 patients who were randomized into 2 wound irrigation groups
undergoing open
preventing infection, especially in wound healing and Owals et al. 2019
Randomized
appendectomy for acute
(0.9% normal saline and 1% diluted Povidone-Iodine solution), a total of 38
Clinical Trial of 200 patients (29%) had signifying wound infection, 29 from normal
appendicitis at Baqai Medical
Surgery Site Infection. University
saline groups and 9 from Povidine-Iodine groups.

MATERIAL AND METHODS DISCUSSIONS

A total of 7 randomized clinical trials assessed the efficacy of Povidone-Iodine in

reducing the rate of infections, especially in Surgical Site Infection. In 4 out of 7 studies,
we found that the usage of Povidone-iodine was proved to have greater risk of
Surgery Site Infection and less effective in reducing the rate of infection. Povidone-
Iodine was thought to cause necrosis of the underlying tissue leading to more
bacterial infection. Consequently, Povidone Iodine should only be used around the
wound over intact skin, and never in the wound itself. However, in the rest of the
Table 1. Search Strategies on Various Databases
studies that proved Povidone-Iodine to be effective, it depends on the calculation of
the number of colonies after swapping at the end of each surgery, which might be the
Inclusion:
reason behind the difference between the result of the studies.
Full-text paper
Type of Study:
Randomized
Controlled Trial
Population:
Patients with
Wound or who
CONFLICT OF INTEREST ACKNOLEDGEMENT
Undergo Surgery
Intervention: The author declares no conflict of The author would like to acknowledge
Povidone-Iodine interest. AMSA-UPH for facilitating the supervisor in
Outcomes:
Reduced Rate of this research.
Infection

Exclusion:
Studies in
languages other
CONCLUSIONS REFERENCES
than English
Irrelevant studies In conclusion, Povidone-Iodine is proven to be less
Study Protocols effective in reducing the rate of infection in wound
No full-text
available
healing and Surgery Site Infection. However, the usage
of Povidone-Iodine can be considered because it is
Figure 1. Literature Search Strategy based on PRISMA Statement more convenient, safer, and more economical.