Povidone-iodine in umbilical cord care interferes with neonatal screening for hypothyroidism

Out of 1346 newborns screened for congenital hypothyroidism, 31 non-hypothyroid infants were summoned because of a thyroid stimulating hormone (TSH) level above 10 U/ml. False-positive TSH levels were significantly more frequent in the babies treated with povidone-iodine (4.6%) than in those treated with either alcohol or triple dye (0.7%).Conclusion Iodine containing solutions should be avoided in umbilical cord care of the newborn     

两种预防新生儿眼炎的药物体外抗菌活性的比较

目的：测定并比较预防新生儿眼炎的硝酸银滴眼液、聚维酮碘滴眼液的体外抗菌活性。方法：采用肉汤二倍稀释法测定最低抑菌浓度和最低杀菌浓度。结果：硝酸银滴眼液对致新生儿眼炎常见的金黄色葡萄球菌、肺炎球菌的MIC50分别为4，8 μg·mL 1，MBC90分别为8，32 μg·mL 1；聚维酮碘滴眼液对该两菌的MIC50分别为64，128 μg·mL 1，MBC90均为256 μg·mL 1。结论：硝酸银滴眼液和聚维酮碘滴眼液对新生儿眼炎常见致病菌都具有抑菌和杀菌作用，但硝酸银滴眼液更适用于对新生儿眼炎预防。     

碘伏膀胱灌注治疗间质性膀胱炎疗效观察

目的探讨0.5%碘伏膀胱灌注治疗间质性膀胱炎(IC)的疗效、安全性及副作用。方法33例IC患者随机分为A、B两组,A组采用0.5%碘伏50ml膀胱灌注,变换体位,保留2h后排空,1次/d,疗程14d;B组用1∶5000呋喃西林溶液替代碘伏,方法同A组。观察治疗前后A、B两组患者症状改善、膀胱镜检变化情况及副作用。结果33例患者随访8~22个月,平均18个月。A、B两组用药后,按O′Leary-Sant IC症状评分(ICSI)、问题评分(ICPI)比较差异均有高度统计学意义(P<0.01)。A组症状缓解15例,有效率83.3%;膀胱镜检所见黏膜下点状出血及Hunner溃疡消失显著12例,好转4例,有效率为88.9%。B组症状缓解7例,有效率为46.7%;膀胱镜检所见黏膜下点状出血及Hunner溃疡消失显著2例,好转3例,有效率33.3%。A组治疗有效率明显高于B组(P<0.01);其尿道灼痛、血尿、发热等副作用低于B组(P<0.05)。结论0.5%碘伏膀胱灌注可安全有效地治疗IC。     

Limitations of peritoneal lavage with antiseptics in prevention of recurrent colorectal cancer caused by tumor-cell seeding

PURPOSE: Exfoliated or soiled free malignant cells have serious consequences in patients undergoing gastrointestinal cancer surgery. The present study evaluates the toxicity and efficacy of cytotoxic agents in the prevention of cell seeding and tumor growth in the peritoneal cavity in an experimental model. METHODS: Mtln3 adenocarcinoma cell viability was testedin vitro using the trypan blue exclusion test after incubation with povidone-iodine or chlorhexidine.In vivo, Fischer rats were inoculated with 10⁵ or 10⁶ cells followed by peritoneal lavage with physiological saline, chlorhexidine 0.02 percent, providone-iodine low molecular weight 1 percent or povidone-iodine high molecular weight 1 and 2 percent in different quantities and incubation times. RESULTS: Chlorhexidine 0.02 percent and povidone-iodine low molecular weight 1 percent or high molecular weight 2 percent, killed over 98 percent of 10⁵ or 10⁶ tumor cellsin vitro. Povidone-iodine low molecular weight 1 percent and high molecular weight 2 percent were toxic and lethal when 5 ml were applied in the peritoneal cavity three times for five minutes. Chlorhexidine 0.02 percent applied after inoculation of 10⁵ or 10⁶ cells, reduced the tumor development only to 70 and 80 percent. Application of 5 ml povidone-iodine 1 percent low molecular weightor high molecular weight, three times for one and five minutes, after inoculation of 10⁶ cells did not change the tumor take. However, inhibition of Mtln3 cells to form metastases was observed. When povidone-iodine low molecular weight 1 percent was used three times for one minute after 10⁵ tumor cells were soiled, no toxicity was observed and the tumor take was reduced to 30 percent (P<0.05). CONCLUSIONS: Povidone-iodine toxicity proved to be a major issuein vivo. However, povidone-iodine low molecular weight 1 percent was safe when used for short periods and very effective when a limited number of tumor cells was inoculated. The use of cytotoxic agents to prevent recurrent disease caused by tumor cell seeding in patients seems to make sense only when the inoculum size of exfoliated or soiled cancer cells is limited.     

Ventral Hernia Repair: a Practical Point of View

Purpose: To evaluate the effect of PVP-I liposome hydrogel on intraperitoneal postoperative adhesions. Material and Methods: Thirty Wistar-Albino male rats were randomly divided into three groups. After midline laparotomy, a 1 cm² area of the caecum was abraded with a sterile gauze until subserosal haemorrhage had developed. A 1 χ 1 cm patch of peritoneum located opposite of caecal abrasion was completely dissected. In group 1 (control group, C) adhesion induction was performed and nothing was applied to the wounds. In group 2 and 3, PVP-I solution (3%) (group 2, PI) and PVP-I liposome hydrogel (group 3, PIL) were applied to the caecal abrasion areas and peritoneal defects. Adhesions were classified according to a classification system based on the evaluation of the appearance, extent and strength of the adhesions on postoperative 21^st day.

Results: There was no significant difference of the adhesion scores between the groups (U1 = 45, p > 0.05; U2 = 48, p > 0.05; U3 = 47.5, p > 0.05).

Conclusions: We found that PVP liposome hydrogel did not influence postoperative intraabdominal adhesions and should be further explored for its potential use in various intraabdominal procedures.     

2％聚维酮碘凡士林纱布在预防阑尾切除术后切口感染中的应用研究

目的 评价2%聚维酮碘凡士林纱布预防阑尾切除术后切口感染临床疗效。方法 2015年11月至2017年3月河北省沧州中西医结合医院收治的阑尾炎180例,区组随机化分为两组,观察组90例以2%聚维酮碘凡士林纱布围绕切口,对照组90例以0.5% 聚维酮碘溶液浸洗切口,比较两组病人术后切口感染率、伤口拆线时间、住院时间以及病人满意度。结果 对照组有10例病人发生切口感染,发生率为11.11%,治疗组术后有3例病人发生切口感染,发生率为3.33%(χ²=4.063,P<0.05);治疗组病人的伤口拆线时间(t=6.499)以及住院时间(t=4.348)显著优于对照组(P<0.05);对照组满意人数为74例,满意率为82.22%,治疗组满意人数为83例,满意率为92.22%(χ²=4.038,P<0.05)。结论 阑尾炎切除术中使用2%聚维酮碘凡士林纱布,能显著降低阑尾炎切口感染率,有利于病人病情康复,缩短病人住院时间,提高病人满意,值得临床进一步研究。     

Combined skin disinfection with chlorhexidine/propanol and aqueous povidone-iodine reduces bacterial colonisation of central venous catheters

Objective Central venous catheter (CVC)-related infections may be caused by micro-organisms introduced from the skin surface into deeper tissue at the time of CVC insertion. The optimal disinfection regimen to avoid catheter-related infections has not yet been defined. This study compares three different approaches.Design Prospective randomised trial.Setting A tertiary care hospital.Patients and participants One hundred nineteen patients scheduled electively to receive 140 CVCs.Interventions Skin disinfection was performed with either povidone-iodine 10% (PVP-iodine), chlorhexidine 0.5%/propanol 70%, or chlorhexidine 0.5%/propanol 70% followed by PVP-iodine 10%. Prior to disinfection, a swab from the site of insertion was taken for culture. CVCs were removed if no longer needed or infection was suspected. All catheters were cultured quantitatively after removal.Measurement and results Bacteria could be isolated from 20.7% of the catheter tips. Bacterial growth was found in 30.8% of the catheters placed after skin disinfection with povidone-iodine, in 24.4% after disinfection with propanol/chlorhexidine and in 4.7% after disinfection with propanol/chlorhexidine followed by povidone-iodine (p=0.006). In 15 cases, the same organism was isolated from the skin swab and the catheter tip. Ten of these paired isolates showed the same pattern in a pulsed-field gel electrophoresis analysis.Conclusions Skin disinfection with propanol/chlorhexidine followed by PVP-iodine was superior in the prevention of microbial CVC colonisation compared to either of the regimens alone. These results support the concept that catheter infections can originate from bacterial translocation at the time of catheter insertion.     

碘伏溶液冲洗胃黏膜对超声内镜引导下细针穿刺术后菌血症发生率的影响

目的研究碘伏溶液冲洗胃黏膜是否能降低超声内镜引导下细针穿刺术（EUS-FNA）后菌血症的发生率。方法选取20条成年杂种犬作为实验动物,随机分成2组,每组10条。实验组FNA术前使用10ml 0．5％碘伏溶液冲洗胃黏膜,对照组FNA术前使用10ml生理盐水。分别于EUS检查前,EUS检查后FNA术前,FNA术后5、15及30min采血进行血培养。结果实验组血培养中3条犬出现有意义的菌血症,对照组1条犬出现有意义的菌血症,对比2组菌血症的发生率,差异无统计学意义（P=0．582）。结论应用0．5％碘伏溶液冲洗胃黏膜不能减少EUS-FNA术后菌血症发生率。     

白内障术前两种不同浓度碘伏液冲洗结膜囊的临床观察

目的比较两种不同浓度（0．05％与0．025％）碘伏液（聚维酮碘）在白内障术前冲洗结膜囊后,患者角膜荧光染色、主觉症状、结膜囊细菌培养等方面的差异,以期找到更安全、有效的白内障术前冲洗结膜囊的碘伏液浓度。方法选择住院行白内障超声乳化术的患者83例（83只眼）,随机分为A、B两组,术前分别采用0．05％碘伏液（A组）、0．025％碘伏液（B组）冲洗结膜囊,比较两组术后患者主观症状、术眼眼表荧光素钠染色评分的差异,以及术前、术后结膜囊采样细菌学培养情况。结果A、B两组浓度的聚维酮碘稀释液均能达到相同的结膜囊细菌消毒效果,但B组较之A组术后患者眼部感觉更舒适,同时客观的眼表损伤更轻微。结论较低浓度（0．025％）的聚维酮碘液在保证有效清除结膜囊细菌的同时,还能明显地降低术后患者的主观不适症状和客观的眼表损伤体征,有利于视功能的更快恢复,可作为临床推广应用。