Bacteria and fungi cause wound infections, which possess a significant problem in healthcare. Thus, effective treatment and prevention are essential. Polyvinylpyrrolidone–iodine (povidone-iodine, PVP-I) is the commercial antimicrobial agent used for skin disinfection, in surgery and for local anti-infective treatment. It has a broad spectrum of activity including numerous species of Gram-positive and Gram-negative bacteria, mycobacteria, fungi, protozoa and viruses. 

European Chemicals Agency, in 2014, approved PVP-I as an existing active substance to be utilized in biocidal products for types 1, 3, 4, and 22 (human hygiene, veterinary hygiene, food and feed area, and embalming and taxidermist fluids). It has shown to be efficient in wound infection treatment, prophylactic intraoperative wound irrigation, hand wash preparations, skin disinfection and topical antiseptic. 

It is employed in the care of surgical wounds, and diabetic foot wounds, as it can rinse deep wounds with lack drainage. 

It has also been demonstrated as a vaginal antiseptic. Presurgical vaginal irrigation with PVP-I remarkably lowers the risk of post-cesarean endometritis, wound infections and pyrexia in women undergoing cesarean delivery.

Evidence also indicates the effectiveness of PVP-I formulations in eradication pathogenic cultures of the external auditory canal after tympanoplasty, in intraocular injection, ophthalmic surgery, also as cataract surgery, in treating the corneal ulcers or preventing post-cystoscopy urinary tract infection (UTI). Furthermore, it is also used for mucosal antisepsis, in oral surgery and dental conditions.

Evidence suggests positive effects of PVP-I gargles/mouthwashes against Bordetella pertussis, Klebsiella pneumoniae and Streptococcus pneumoniae strains. However, another crucial factor determining the proper healing process remains the low cytotoxicity of the antiseptic.

Currently, the most frequented antiseptics for the prevention and treatment of chronic wounds in clinics are octenidine and iodine-containing agents (such as iodine povidone).

Sometimes, sensitizations against PVP-I cross-reacts to iodinated contrast media, which can be detected by a simple skin test. In addition, PVP-I allergies are rather rare. Contraindications to povidone-iodine usage are described in Hypersensitivity to the povidone-iodine, hyperthyroidism, toxic nodular goitre, herpes dermatitis syndrome, radioactive iodine therapy and peritoneal lavage. Application during pregnancy and breastfeeding and in patients under 12 years old is not recommended.

Thus Povidone-iodine is a relatively inexpensive antimicrobial agent with a broad spectrum of activity, efficacy against biofilms and no resistance. Its rapid action and good tolerability make it a choice in the clinical treatment of surgical wounds and the prevention of infections. Its use may help reduce the wound healing period and shorten the hospitalization as well as reduce the treatment costs.

Source: Gmur MK, KarpiÅ„ski TM. Povidone-iodine in wound healing and prevention of wound infections. European Journal of Biological Research, 2020;10(3), 232–239. https://doi.org/10.5281/zenodo.3958220