Authors (including presenting author) :
Ip SH, Ting KH, & Yu T
Affiliation :
Rehabilitation Department, KH
Introduction :
Betadine ointment (chemical name: Povidone iodine (PVP-I) ointment) was developed in 1950s. It is a compound of polyvinylpyrrolidone (PVP) and elemental iodine, when in an aqueous medium, are known to release a low concentration of free iodine slowly that acts as an antiseptic with bactericidal activity over a sustained period of time to protect against inhibition of granulation tissue formation, thereby promoting wound healing. So they have been found to be safer and less painful, allowing widespread use in wound management since 1950s. Besides, it is well known by its broad antimicrobial spectrum against bacteria, viruses, fungi, endospores and antibiotic-resistant bacterial strains without resistance or cross-resistance reported for chronic wound care. Chronic wounds were estimated affect about 3% of people over 60 years of age. In my workplace - a rehabilitation unit, there is about 20 to 25% patients having chronic wounds lasted for months or even years. Patients with chronic wounds are prone to have high morbidity and wound infection and cause a drain on already limited health care resources. Hence, they become a significant problem for health-care system worldwide. Apart from age, malnutrition, DM, the major barriers for chronic wound healing are wound infection and immunodeficiency. The escalating prevalence of bacterial resistance to antibiotics and multidrug-resistant strains of organisms make many of them cannot be used, so, antiseptics and antimicrobial dressings that have no bacterial resistance, such as Betadine, are continuously explored for alternatives of antibiotics. From literature reviews, many studies are found reporting effectiveness of Betadine solution, very few of Betadine ointment. This paper is to fill this research gap to report the effectiveness of 10% Betadine ointment on chronic wound healing for patients with long-term illnesses.
Objectives :
This paper is to retrospectively review chronic wound cases in 2019 to explore the effectiveness of 10% betadine ointment in decrease of local infection signs (slough, erythema, overgrowth tissue), and in wound healing (decrease in size or wound closure with 100% re-epithelialization).
Methodology :
Computerized chronic wound records with clinical photographs of all cases that were followed up by Department wound care service and used Betadine ointment therapy in 2019, were sorted out. The data of the wound condition at pre- and post-treatment were then organized, analysed and synthesized to report its effectiveness on chronic wound healing.
Result & Outcome :
In 2019, the chronic wound treatment records of 20 patients (25 no. of wounds) using Betadine ointment were reviewed. They include pressure injuries (14, 56%), leg ulcers (4,16%), infected surgical wounds (2, 8%), and others (extravasation injury, carbuncle and etc, 5, 20%). The characteristics of patients were: male (6, 30%) and female (14, 70%); age (mean:68.9, range: 23 -98, SD: 20.7), all with multiple morbidities. The average length of treatment was 25.6 days (range: 5-96, SD: 19.3). Before Betadine ointment application, for sloughy wounds (11, 44%), deep cleansing plus debridement had been performed; for wounds with biofilms and debris (8, 32%) deep cleansing had been offered. For infection reduction, among the 17 sloughy wounds, 13 (76.5%) had slough decrease; among the 8 wounds with erythema, all (100%) subsided; among the 3 with overgrowth tissue, all (100%) were treated. For wound healing, among the 25 wounds, 14 (56%) had size decrease and 5 (20%) had wound closure with 100% re-epithelialization. For adverse effects in hypersensitivity, among the 25 wounds, no such sign was observed and recorded. In conclusion, 10% Betadine ointment was effective with good percentage on chronic wound healing (76%) and reduction of different infection signs (76% to 100%). The limitations are small number of cases and lack of thyroid dysfunctions report for safety issue.
