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Review
. 2023 Mar 16:13:9-17.
doi: 10.1016/j.sopen.2023.03.005. eCollection 2023 Jun.

Evaluation of the role of povidone‑iodine in the prevention of surgical site infections

Stan J Monstrey  1 , Kris Govaers  2 , Patrice Lejuste  3 , Didier Lepelletier  4 , Paulo Ribeiro de Oliveira  5
Affiliations
Review

Evaluation of the role of povidone‑iodine in the prevention of surgical site infections

Stan J Monstrey et al. Surg Open Sci. .

Abstract

Background: The occurrence of surgical site infections (SSIs) is associated with increased risk of mortality, development of other infections, and the need for reintervention, posing a significant health burden. The aim of this review was to examine the current data and guidelines around the use of antiseptic povidone‑iodine (PVP-I) for the prevention of SSIs at each stage of surgical intervention.

Methods: A literature search for selected key words was performed using PubMed. Additional papers were identified based on author expertise.

Results: Scientific evidence demonstrates that PVP-I can be used at every stage of surgical intervention: preoperative, intraoperative, and postoperative. PVP-I is one of the most widely used antiseptics on healthy skin and mucous membranes for preoperative surgical site preparation and is associated with a low SSI rate. For intraoperative irrigation, aqueous PVP-I is the recommended agent and has been demonstrated to decrease SSIs in a range of surgical settings, and for postoperative wound healing, there is a growing body of evidence to support the use of PVP-I.

Conclusions: There is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation. The use of a single agent (PVP-I) at each stage of surgical intervention could potentially provide advantages, including economic benefits, over agents that can only be used at discrete stages of the surgical procedure.

Key message: Evidence supports the use of PVP-I at all stages of surgical intervention, from preoperative measures (including skin preparation, preoperative washing, and nasal decolonization) to intraoperative irrigation, through to postoperative wound management. However, there is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation.

Keywords: Antiseptic; Decolonization; Povidone‑iodine; Surgical site infection; Wound healing.

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Conflict of interest statement

SM declares that he has nothing to disclose. DL has served as a consultant for Viatris. KG declares that he has nothing to disclose. PL has served as a consultant for Viatris. PRO declares that he has nothing to disclose.

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