Among various antimicrobial agents, iodophore-based formulations such as povidone-iodine remain popular even after decades of use for antisepsis and wound healing due to their favorable efficacy and tolerability. 

There is a strong preference for povidone iodine due to its broad spectrum of activity, ability to penetrate biofilms, lack of associated resistance, anti-inflammatory properties, low cytotoxicity, and good tolerability; furthermore, it has no negative effect on wound healing. The past few decades have provided numerous published reports on povidone-iodine use; however, many of these studies have differing designs, endpoints, and quality. More recent data sustains its use in wound healing.

Based on data gathered through PubMed and the author′s clinical experience, an article by Bigliardi PL et al. reviews preclinical and clinical safety and efficacy data on povidone-iodine use in wound healing and its implications for the control of infection and inflammation. 

It highlights that there exists evidence of antiseptics use in preference to topical and systemic antibiotics for localized skin infections. 

Clinically, wound healing in clean wounds is not impeded and in colonized wounds is supported. PVP-Is use is especially important for sensitive and difficult-to-treat wounds and in the case of chronic wounds where there is a probability of extended duration of therapy. 

Some combinations, like medicated gauzes, make antiseptic formulations easier to apply. Innovative application methods and formulations, such as using iodine in wound healing devices or carriers such as liposomes, have extended the reach of existing formulations. 

The review underlines that Povidone iodine′s unique characteristics position it extraordinarily well for wound healing. Its rapid, potent, broad-spectrum antimicrobial properties, and favorable risk/benefit profile, keeps it a highly effective treatment for acute and chronic wounds in the foreseeable future.

Source: Bigliardi PL, Alsagoff SAL, El-Kafrawi HY, Pyon JK, Wa CTC, Villa MA. Povidone iodine in wound healing: A review of current concepts and practices. Int J Surg. 2017 Aug;44:260-268. doi: 10.1016/j.ijsu.2017.06.073. Epub 2017 Jun 23. PMID: 28648795.