DOCSLIB.ORG

A Study of the Effect of Povidone-Iodine on Wound Healing 0

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Study of the Effect of Povidone-Iodine on Wound Healing 0 Postgraduate Medical Journal (March 1977) 53, 122-125. Postgrad Med J: first published as 10.1136/pgmj.53.617.122 on 1 March 1977. Downloaded from A study of the effect of povidone-iodine on wound healing 0. J. A. GILMORE CLARE REID M.S., F.R.C.S., F.R.C.S.Ed. B.Sc., A.I.M.L.S. A. STROKON F.R.C.S.Ed. Surgical Professorial Unit, St Bartholomew's Hospital, London E.C.I and North Middlesex Hospital, London N.18 Summary of a substance other than pus' (Pollock, 1973). The effect of dry powder povidoneiodine (Disadine For this reason the clinical evaluation was under- D.P.) on wound healing was assessed experimentally taken in patients undergoing elective, 'clean', and clinically. It did not interfere with wound healing non-abdominal operations. macroscopically, histologically or mechanically in Wistar rats. One hundred and one patients undergoing Materials and methods 'clean' elective surgery were included in the controlled Experimental study clinical study and povidone-iodine did not affect Seventy-two female, specific pathogen-free, Wistar wound healing in any way. In the control group 4% rats weighing 220-250 g were used in this study.Protected by copyright. of patients developed infection compared with none Under ether anaesthesia following shaving and skin of those sprayed with povidone-iodine. No adverse disinfection with chlorhexidine gluconate 0-5% in reaction to povidone-iodine was seen in either study. 70% methylated spirit, a 4-cm, vertical, mid-line This antiseptic offers a safe alternative to antibiotics incision was made through all layers of the anterior for use at operation whenever there is risk of wound abdominal wall. A card was then drawn allocating infection from operative bacterial contamination. the rat to one of two groups. The wounds of the thirty-six rats in group A remained as untreated Introduction controls. The open wounds of the thirty-six rats in Interparietal, dry powder povidone-iodine (Disa- group B were sprayed with dry powder povidone- dine D.P.) sprayed into the wound just before iodine (Disadine D.P.) for 5 sec, from a distance of closure significantly reduces infection after potenti- approximately 25 cm. All wounds were closed in ally contaminated abdominal operations (Gilmore one layer with seven interrupted 2/0 black silk and Sanderson, 1975). It reduces wound infection sutures, each separated by a gap of 0-5 cm. http://pmj.bmj.com/ after gridiron appendicectomy and is at least as effective as a polyantibiotic spray containing Assessment of wound healing neomycin, bacitracin and polymixin (Gilmore, Wound healing was assessed macroscopically, Martin and Fletcher, 1973; Gilmore and Martin, histologically and mechanically in ignorance of the 1974). Numerous antiseptics, however, damage treatment group. the tissues and inhibit healing (Branemark and Macroscopic assessment was made in six rats per Ekholm, 1967). Pollock and Evans (1975) suggested group at 3, 5, 7, 14 and 28 days after operation. that povidone-iodine acted as a wound irritant and Wounds were inspected for inflammation, excoria- on September 29, 2021 by guest. caused secondary sepsis. tion and wound and stitch abscess formation. An experimental study using rats was therefore Histological assessment was made in three rats per carried out to determine the effect of povidone- group at 7 and 28 days after operation. Following iodine on wound healing, and a clinical trial deter- killing with ether a rectangle of anterior abdominal mined whether it causes secondary sepsis. Late wall measuring 2 x 1 cm was excised from each rat in wound infections often occur after potentially such a way that there was 1 cm of tissue either side of contaminated abdominal procedures (Gilmore and the healing incision. Sections were stained with Martin, 1974; Gilmore and Sanderson, 1975) and haematoxylin and eosin and examined under high cannot always be differentiated from secondary and low power magnification. sepsis 'that which follows discharge from the wound Mechanical assessment was carried out in six rats Correspondence: Mr 0. J. A. Gilmore, St Bartholomew's per group at 3, 5, 7, 14 and 28 days after operation. Hospital, West Smithfield, London EC1A 7BE. The bursting strength of the abdominal wound was Povidone-iodine and wound healing 123 Postgrad Med J: first published as 10.1136/pgmj.53.617.122 on 1 March 1977. Downloaded from measured in the manner described by Prudden, the patient returned home was included in the in- Nishihara and Baker (1957) and de Haan, Ellis and fected group. Wilks (1974). The rats were killed with ether; any remaining sutures were then carefully divided but not Statistical methods removed. A pair of Spencer Wells forceps was The mean bursting pressure of the rat abdomen inserted into the peritoneal cavity through a defect was calculated for each treatment group on each day made in the apex of the vagina. A fingercot (Regent of killing. These means were compared using an Medical Fingercot. L.R.I. Ltd) was then inserted via unpaired Student's t-test with standard deviation. the same route and connected by a 'Y' junction to a The same test was used in the clinical study for mercury manometer and a cylinder of carbon di- comparison of continuous variables, i.e. age, oxide. The pressure was raised at a constant rate of duration of operation and length of incision. The 5 mmHg/sec until the abdomen burst. X2 test was used for two analyses: distribution of patients between the two treatment groups according Clinical study to build and the number of patients in each group One hundred and one consecutive patients at the operated on by individual surgeons. Fisher's exact North Middlesex Hospital, London, undergoing test (Fisher, 1935) was used to analyse data related elective, 'clean', non-abdominal operations were to the patient's sex and the type of operation. included in this study. Random allocation of patients to one of two groups was achieved by using a table Results of random numbers; the code in the form of an Experimental study 'Advent Calendar' was kept outside the theatre. The Macroscopic assessment. The wounds were found surgeon was informed of the spraying procedure to to be soundly healed in all rats sprayed with povi- be used before he started the wound. The done-iodine. In the control two rats had areas just closing group Protected by copyright. open wounds of patients in group S were sprayed of excoriation in the vicinity of the wound, three with dry powder povidone-iodine and the wounds of had wound abscesses and one a stitch abscess. Two the patients in group T with the propellant alone rats in the povidone-iodine group had evidence of (dichlorodifluoromethane and trichlorofluorometh- superficial infection and one had a bead of pus at a ane). Spraying was carried out by the runner nurse or stitch site. There was no evidence of reaction to the theatre technician who, having shaken the aerosol, povidone-iodine in any rat. sprayed the open wound for 10 sec from approxi- Histology. At 1 week there was hyperplasia of the mately 25 cm. The deeper layers of all wounds were epidermis in all specimens. Granulation tissue was closed with chromic catgut and the skin with inter- visible between the divided dermis, subcutaneous rupted 2/0 black silk. All closed wounds were tissue and panniculus carnosus. Macrophages, sprayed with nobecutane, no other dressing being foreign body giant cells and some polymorphonuc- applied. lear cells were visible in both groups around hairs A standard form was completed at the end of each and suture material in the interparietal granulation operation recording the patient's age, sex, diagnosis tissue. These changes were no more marked in one http://pmj.bmj.com/ and build. Patients with less than 1 cm of sub- group than the other. cutaneous tissue were classified as thin, those with It was equally difficult to see the incision his- 1-2-5 cm as average and those with more than 2-5 cm tologically in all rats at 1 month. The sites of the as obese. The operative procedure, the type of divided rectus muscles were visible and were joined incision, its length, the duration of the operation, by new muscle and fibrous tissue in similar propor- the surgeon, and whether the patient was given tions in both groups. A layer of fibrous tissue was antibiotics were also recorded. visible in all animals between the muscle and healing on September 29, 2021 by guest. All wounds were inspected in ignorance of the the healed peritoneum. Although examination of spraying procedure used by the registrar from the the sections taken from the incisions at 1 week and 1 firm which had not performed the operation. A month showed some individual variations in careful watch was kept for evidence of inflammation, appearance, there was no consistent change in one excoriation, discharge and local or general reactions. group. The criteria of Ljungquist (1964) were adopted with Burstingpressures. The mean bursting pressures of regard to infection. The wound was either clean or the abdominal wounds of the rats in both groups on infected. It was infected if at any time a purulent the different days are shown as a histogram in Fig. 1. discharge occurred. If a serous discharge appeared When these are compared there is no statistical it was swabbed, cultured, and the wound classified significance between the two groups on any day. The according to the resultant culture. mean bursting pressure rose sharply between the All wounds were inspected at follow-up 6 weeks third and seventh post-operative days and then after operation. Any wound discharging pus after levelled out. 124 0. J. A.
Load more

Recommended publications
  • Eosin Y Catalysed Photoredox Synthesis: a Review
    RSC Advances REVIEW View Article Online View Journal | View Issue Eosin Y catalysed photoredox synthesis: a review a b Cite this: RSC Adv.,2017,7,31377 Vishal Srivastava and Praveen P. Singh * In recent years, photoredox catalysis using eosin Y has come to the fore front in organic chemistry as a powerful strategy for the activation of small molecules. In a general sense, these approaches rely on the ability of organic dyes to convert visible light into chemical energy by engaging in single-electron Received 14th May 2017 transfer with organic substrates, thereby generating reactive intermediates. In this perspective, we Accepted 13th June 2017 highlight the unique ability of photoredox catalysis to expedite the development of completely new DOI: 10.1039/c7ra05444k reaction mechanisms, with particular emphasis placed on multicatalytic strategies that enable the rsc.li/rsc-advances construction of challenging carbon–carbon and carbon–heteroatom bonds. 1. Introduction However, the transition metal based photocatalysts disadvantageously exhibit high cost, low sustainability and Visible light photoredox catalysis has recently received much potential toxicity. Recently, a superior alternative to transition Creative Commons Attribution 3.0 Unported Licence. attention in organic synthesis owing to ready availability, metal photoredox catalysts, especially metal-free organic dyes sustainability, non-toxicity and ease of handling of visible particularly eosin Y has been used as economically and 1–13 light but the general interest in the eld started much ecologically superior surrogates for Ru(II)andIr(II)complexes earlier.14 Unlike thermal reactions, photoredox processes occur in visible-light promoted organic transformations involving 18–21 under mild conditions and do not require radical initiators or SET (single electron transfer).
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 De Juan Et Al
    US 200601 10428A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 de Juan et al. (43) Pub. Date: May 25, 2006 (54) METHODS AND DEVICES FOR THE Publication Classification TREATMENT OF OCULAR CONDITIONS (51) Int. Cl. (76) Inventors: Eugene de Juan, LaCanada, CA (US); A6F 2/00 (2006.01) Signe E. Varner, Los Angeles, CA (52) U.S. Cl. .............................................................. 424/427 (US); Laurie R. Lawin, New Brighton, MN (US) (57) ABSTRACT Correspondence Address: Featured is a method for instilling one or more bioactive SCOTT PRIBNOW agents into ocular tissue within an eye of a patient for the Kagan Binder, PLLC treatment of an ocular condition, the method comprising Suite 200 concurrently using at least two of the following bioactive 221 Main Street North agent delivery methods (A)-(C): Stillwater, MN 55082 (US) (A) implanting a Sustained release delivery device com (21) Appl. No.: 11/175,850 prising one or more bioactive agents in a posterior region of the eye so that it delivers the one or more (22) Filed: Jul. 5, 2005 bioactive agents into the vitreous humor of the eye; (B) instilling (e.g., injecting or implanting) one or more Related U.S. Application Data bioactive agents Subretinally; and (60) Provisional application No. 60/585,236, filed on Jul. (C) instilling (e.g., injecting or delivering by ocular ion 2, 2004. Provisional application No. 60/669,701, filed tophoresis) one or more bioactive agents into the Vit on Apr. 8, 2005. reous humor of the eye. Patent Application Publication May 25, 2006 Sheet 1 of 22 US 2006/0110428A1 R 2 2 C.6 Fig.
    [Show full text]
  • Hematoxylin and Eosin Stain (H&E)
    Hematoxylin and Eosin Stain (H&E) TECHNIQUE: Formalin fixed, paraffin tissue sections REAGENTS: Mayer’s Hematoxylin (Source Medical, catalog# 9235360) 0.5% Acid Alcohol 70% Ethanol ----------------------------------------------------------------------995ml Hydrochloric Acid, (36.5% - 38%) ------------------------------------------- 5ml 1X PBS (pH 7.2-7.3) Alcoholic-Eosin 1.0% Eosin Y Eosin Y (CAS# 17372-87-1) -------------------------------------------------- 1.0 g Distilled water ------------------------------------------------------------------ 100 ml 1.0% Phloxine B Phloxine B (CAS# 18472-87-2) ---------------------------------------------- 0.5 g Distilled water ------------------------------------------------------------------ 50.0 ml Working Alcoholic-Eosin Solution 1.0% Eosin Y ------------------------------------------------------------------- 50.0 ml 1.0% Phloxine B --------------------------------------------------------------- 5.0 ml 95% Ethanol -------------------------------------------------------------------- 390.0 ml Acetic acid, glacial ------------------------------------------------------------- 4.0 ml 11/2018 Hematoxylin and Eosin Stain (H&E) 5 micron Paraffin Sections PROCEDURE: 1. Deparaffinize and rehydrate slides to distilled water 2. Stain in Mayers Hematoxylin for 1 minute 3. Wash with 4-5 changes of Tap water or until blue stops coming off slides 4. Blue nuclei in 1X PBS for 1 minute 5. Wash with 3 changes of distilled water 6. Counterstain in Alcoholic-Eosin for 1 minute (DO NOT RINSE) 7. Dehydrate through 3
    [Show full text]
  • Outcomes of Conservative Treatment of Giant Omphaloceles with Dissodic 2% Aqueous Eosin: 15 Years' Experience
    Access this article online Website: Original Article www.afrjpaedsurg.org DOI: 10.4103/0189-6725.132825 PMID: *** Outcomes of conservative treatment of giant Quick Response Code: omphaloceles with dissodic 2% aqueous eosin: 15 years’ experience B. D. Kouame, T. H. Odehouri Koudou, J. B. Yaokreh, M. Sounkere, S. Tembely, K. G. S. Yapo, R. Boka, M. Koffi, A. G. Dieth, O. Ouattara, A. da Silva, R. Dick INTRODUCTION ABSTRACT Background: The surgical management of giant Surgical treatment of the giant omphaloceles leads to omphalocele is a surgical challenge with high several haemodynamic and respiratory complications mortality and morbidity in our country due to the which increase their mortality. To reduce the morbidity absence of neonatal resuscitation. This study evaluates conservative management of giant and the mortality of the surgical management of the giant omphalocele with dissodic 2% aqueous eosin. omphalocele, conservative’s treatments with antiseptic Materials and Methods: In the period from January solutions were carried out.[1-3] Povidone iodine and 1997 to December 2012, giant omphaloceles were merbromin have been used during several years due to their treated with dissodic 2% aqueous eosin. The capacity to promote escharification and epithelialization procedure consisted of twice a day application of of the omphalocele sac. However due to complications dissodic 2% aqueous eosin (sterile solution for topical application) on the omphalocele sac. The such as transient hypothyroidism with povidone iodine or procedure was taught to the mother to continue mercury poising with merbromin, there was the cessation at home with an outpatient follow-up to assess of their use for conservative treatment.[1-4] epithelialization.
    [Show full text]
  • Eosin Staining
    Science of H & E Andrew Lisowski, M.S., HTL (A.S.C.P.) 1 Hematoxylin and Eosin Staining “The desired end result of a tissue stained with hematoxylin and eosin is based upon what seems to be almost infinite factors. Pathologists have individual preferences for section thickness, intensities, and shades. The choice of which reagents to use must take into consideration: cost, method of staining, option of purchasing commercially-prepared or technician-prepared reagents, safety, administration policies, convenience, availability, quality, technical limitations, as well as personal preference.” Guidelines for Hematoxylin and Eosin Staining National Society for Histotechnology 2 Why Do We Stain? In order to deliver a medical diagnosis, tissues must be examined under a microscope. Once a tissue specimen has been processed by a histology lab and transferred onto a glass slide, it needs to be appropriately stained for microscopic evaluation. This is because unstained tissue lacks contrast: when viewed under the microscope, everything appears in uniform dull grey color. Unstained tissue H&E stained tissue 3 What Does "Staining" Do? . Contrasts different cells . Highlights particular features of interest . Illustrates different cell structures . Detects infiltrations or deposits in the tissue . Detect pathogens Superbly contrasted GI cells Placenta’s large blood H&E stain showing extensive vessels iron deposits There are different staining techniques to reveal different structures of the cell 4 What is H&E Staining? As its name suggests, H&E stain makes use of a combination of two dyes – hematoxylin and eosin. It is often termed as “routine staining” as it is the most common way of coloring otherwise transparent tissue specimen.
    [Show full text]
  • Photophysical and Antibacterial Activity of Light- Activated Quaternary Eosin Y
    Open Chem., 2019; 17: 1244–1251 Research Article Desislava Staneva, Stanislava Yordanova*, Evgenia Vasileva-Tonkova, Stanimir Stoyanov, Ivo Grabchev Photophysical and antibacterial activity of light- activated quaternary eosin Y https://doi.org/10.1515/chem-2019-0135 received December 3, 2018; accepted May 9, 2019. Keywords: eosin Y, photophysics, antimicrobial activity, antibacterial textile Abstract: The functional characteristics of a new eosin dye with biocidal quaternary ammonium group (E) were studied in aqueous solution and in organic solvents of 1 Introduction different polarity. The spectral properties depend on the nature and polarity of the respective solvents. The Fluorescent compounds are often used in medicine, antimicrobial activity of compound E has been tested in pharmacy, biology and environmental protection [1,2]. vitro against Gram-negative bacteria (Escherichia coli, Among the known fluorophore structures used in these Acinetobacter johnsoni and Pseudomonas aeruginosa), fields, the eosin Y and its derivatives are very important. Gram-positive bacteria (Sarcina lutea and Bacillus cereus) They belong to the group of xanthene fluorescent dyes and the antifungal activity was tested against the yeasts with a wide range of photophysical and biological Candida lipolytica in solution and after treated on cotton applications, due to their low toxicity in vivo, and high fabric. Broth dilution test has been used for quantitative water solubility [3]. The utility of eosin derivatives is evaluation of the antimicrobial activity of compound E associated to their good spectral characteristics and the against the model strains. The ability of compound E to possibility to interact with different type of biomolecules inhibit the growth of model Gram-negative P.
    [Show full text]
  • Basics of Hematology and Patho-Histology
    Basics of Hematology and Patho-histology Practical Course in Molecular Pathology Winter Term 2015 Ernst Müllner MFPL (Max F Perutz Laboratories) Department of Medical Biochemistry Medical University of Vienna [email protected] www.mfpl.ac.at/mfpl-group/group/muellner.html (Müllner homepage / research) E. coli + macrophages medicalschool.tumblr.com/post/43914024728/sem-image-of-e-coli-bacteria-and-macrophages medicalschool.tumblr.com/post/18256087351/r ed-blood-cells-erythrocytes-trapped-by-fibrin Overview on main white blood cell (WBC) types – (Wikipedia) Mature white blood cell types I White Blood cells (WBCs) are frequently also referred to as peripheral blood mononuclear cells (PBMCs). Granulocytes in general are part of the innate immune system. Names derive from staining with hematoxylin and eosin. Whereas basophils stain dark blue and eosinophils are bright red, neutrophils stain neutral to pink. Basophil granulocytes Eosinophil granulocytes Neutrophil granulocytes Least common granulocyte type About 1-6% of WBCs; component Most abundant WBC type (40- (0.01- 0.3% of WBCs. Large of innate immune system to com- 75%) and essential part of the cytoplasmic granules obscure the bat parasites and certain infec- innate immune system. A patho- nucleus under the microscope. tions; also associated with allergy gen is likely to first encounter a When unstained, the nucleus is and asthma. Following activation, neutrophil. Normally contain a nu- visible and usually has 2 lobes. eosinophils effector functions in- cleus of 2-5 lobes. Neutrophils Basophils appear in inflammatory clude production and release (de- quickly congregate at a infection reactions, particularly those granulation) of cytotoxic substan- site, attracted by cytokines from causing allergies, mainly via the ces (granule proteins, reactive activated endothelium, mast cells, vasodilator histamine (antihistami- oxygen species …) and production or macrophages.
    [Show full text]
  • Hematoxylin & Eosin
    Washington University School of Medicine Neuromuscular Lab CAP: 1923316 CLIA: 26D0652044 NY: PFI 3499 HEMATOXYLIN & EOSIN (H & E) STAIN PROTOCOL PRINCIPLE: This protocol is applied in the routine staining of cationic and anionic tissue components in tissue sections. This is the standard reference stain used in the study of histochemical tissue pathology. SPECIMEN REQUIRED: Snap frozen human striated muscle. (Use the 2-methylbutane freezing method) METHOD: Fixation: None. Use snap frozen tissue. Technique: Cut 10 - 16 micron (12 µm) sections in cryostat from snap frozen biopsy. Attach first and last sections to a Superfrost Plus microscope slide. Equipment: Ceramic staining rack - Thomas Scientific #8542-E40 Columbia staining dish - Thomas Scientific #8542-C12 Columbia staining dish(jar) - Thomas Scientific #8542-E30 Forceps Latex gloves Reagents: Reagent alcohol - HPLC Fisher A995-4 or histological A962, FLAMMABLE store at room temp. in a flammable cabinet Eosin Y, disodium salt (Sigma #E-6003, store at room temperature) Harris Hematoxylin Stain, acidified (Lerner Laboratories #1931382)(R.T.) Permount - Fisher SP15-100, FLAMMABLE; HEALTH HAZARD Xylenes (Fisher #HC700-1GAL, FLAMMABLE Solutions: I. Eosin Y, 1 % aqueous (store at room temperature) Eosin Y dye 1 g Deionized water 100 ml H&E protocol.docx 1997 Washington University School of Medicine Neuromuscular Lab CAP: 1923316 CLIA: 26D0652044 NY: PFI 3499 2. Harris Hematoxylin, acidified (store at room temperature) Filter (Baxter #F2217-150, Grade 363, Qualitative) before use 3. Alcohol 50 % reagent alcohol ~50 ml deionized water ~50 ml 4. Alcohol 70 % reagent alcohol ~70 ml deionized water ~30 ml 5. Alcohol 80 % reagent alcohol ~80 ml deionized water ~20 ml 6.
    [Show full text]
  • Triclosan Leads to Dysregulation of the Metabolic Regulator FGF21 Exacerbating High Fat Diet-Induced Nonalcoholic Fatty Liver Disease
    Triclosan leads to dysregulation of the metabolic regulator FGF21 exacerbating high fat diet-induced nonalcoholic fatty liver disease Mei-Fei Yueha, Feng Heb, Chen Chena, Catherine Vua, Anupriya Tripathic, Rob Knightc, Michael Karinb,1, Shujuan Chena, and Robert H. Tukeya,1 aLaboratory of Environmental Toxicology, Department of Pharmacology, University of California San Diego, La Jolla, CA 92093; bLaboratory of Gene Regulation and Signal Transduction, Department of Pharmacology, University of California San Diego, La Jolla, CA 92093; and cDepartment of Pediatrics, University of California San Diego, La Jolla, CA 92093 Contributed by Michael Karin, October 13, 2020 (sent for review August 13, 2020; reviewed by Christopher A. Bradfield and Bhagavatula Moorthy) Triclosan (TCS), employed as an antiseptic and disinfectant, comes steatosis, have become a useful experimental animal model for into direct contact with humans through a plethora of consumer research on NAFLD, NASH, and TASH (4). products and its rising environmental release. We have demon- The environmental contaminant triclosan (TCS) is a ubiqui- strated that TCS promotes liver tumorigenesis in mice, yet the tous antimicrobial present in a myriad of consumer products as biological and molecular mechanisms by which TCS exerts its well as various environmental compartments. Ecotoxicology toxicity, especially in early stages of liver disease, are largely studies have showed that TCS is one of the most commonly unexplored. When mice were fed a high-fat diet (HFD), we found encountered contaminants in solid and water compartments and that fatty liver and dyslipidemia are prominent early signs of liver has been detected in levels from nanograms to several micro- abnormality induced by TCS.
    [Show full text]
  • Hemorrhagic Vesiculobullous Eruption on the Palms and the Soles As Presentation of Dyshidrosiform Bullous Pemphigoid
    CASE REPORT Hemorrhagic vesiculobullous eruption on the palms and the soles as presentation of dyshidrosiform bullous pemphigoid Andrea Michelerio, MD,a Giorgio Alberto Croci, MD,b Camilla Vassallo, MD, PhD,a and Valeria Brazzelli, MDa Pavia, Italy Key words: bullous pemphigoid; bullous tinea pedis; dyshidrosiform pemphigoid; pompholyx. INTRODUCTION Abbreviations used: Dyshidrosiform bullous pemphigoid (DP) is an unusual localized variant of bullous pemphigoid BP: bullous pemphigoid DP: dyshidrosiform pemphigoid (BP), first described by Levine et al1 in 1979. It presents with a persistent and recurrent vesicobul- lous eruption, sometimes hemorrhagic, localized to the soles and/or palms. Since the clinical manifesta- improvement was noted. When the patient pre- tions of DP are similar to those of pompholyx or sented to our clinic, multiple tense vesiculobullae bullous tinea pedis, which are more common and (some hemorrhagic) on the nonerythematous skin of benign dermatologic diseases, a proper diagnosis the palms, the soles, and lateral surfaces of both could be delayed. We report the case of an 82-year- hands and feet were present (Fig 1). No mucosal or old man affected by DP who was treated for months other cutaneous involvement was observed, and the for pompholyx and bullous tinea pedis with derma- Nikolsky sign was negative. Mycologic examination tophytid reaction. with potassium hydroxide preparation and a fungal culture from skin scrapings found no trace of fungal CASE REPORT elements. The patient denied consistent exposure to An 82-year-old man presented with a few-months’ allergens or products that might induce persistent history of recurrent itchy vesicobullous eruption contact dermatitis. A skin biopsy from the lateral foot localized to the soles and the palms.
    [Show full text]
  • Evaluation of the Skin Flora After Chlorhexidine and Povidone-Iodine
    Available online at www.sciencedirect.com Surgical Neurology 71 (2009) 207–210 www.surgicalneurology-online.com Infection Evaluation of the skin flora after chlorhexidine and povidone-iodine preparation in neurosurgical practice ⁎ Aslan Guzel, MDa, , Tuncer Ozekinci, MDb, Umit Ozkan, MDa, Yusuf Celik, PhDc, Adnan Ceviz, MDa, Deniz Belen, MDd Departments of aNeurosurgery, bMicrobiology and cBiostatistics, University of Dicle, 21180 Diyarbakir, Turkey dDepartment of Neurosurgery, Ministry of Health, Diskapi Educational and Research Hospital, 06510 Ankara, Turkey Received 25 September 2007; accepted 16 October 2007 Abstract Background: Currently, there are various antiseptics used for cleaning the skin before surgery, but there is no standard procedure in practice. Chlorhexidine and povidone-iodine are the most preferred compounds among antiseptics. Both are proved to be safe and effective for skin disinfection. In this study, our aim was to investigate the combined effects of chlorhexidine and povidone-iodine on the skin's flora before neurosurgical intervention, consecutively. Methods: Randomly, 50 cranial and 50 spine neurosurgery cases were assigned to the study. The first culture was obtained after hair removal and before cleaning the skin with any antiseptic. The second culture was obtained after the skin had been cleaned with chlorhexidine for 3 minutes. Then, the skin was cleaned twice with povidone-iodine for 30 seconds, and the third and fourth cultures were taken from the skin incision area. Bacteria were identified by means of standard laboratory identification methods. Positive culture results were compared statistically among order of cultures obtained. Results: In the first culture evaluation, 39 (33 cnS, 6 Stapylococcus aureus) of 50 cranial samples and 37 (33 cnS, 4 S aureus) of 50 spine samples showed reproduction.
    [Show full text]
  • Chlorhexidine-Releasing Implant Coating on Intramedullary Nail Reduces Infection in a Rat Model S.M
    EuropeanSM Shiels Cellset al. and Materials Vol. 35 2018 (pages 178-194) DOI: 10.22203/eCM.v035a13 Chlorhexidine coating reduces ISSNbone infection 1473-2262 CHLORHEXIDINE-RELEASING IMPLANT COATING ON INTRAMEDULLARY NAIL REDUCES INFECTION IN A RAT MODEL S.M. Shiels1,*, M. Bouchard2, H. Wang2 and J.C. Wenke1 1 United States Army Institute of Surgical Research, Extremity Trauma and Regenerative Medicine Task Area, Joint Base San Antonio-Fort Sam, Houston, Texas, USA 2 Teleflex Inc., Cambridge, Massachusetts, USA Abstract The use of internal intramedullary nails for long bone fracture fixation is a common practice among surgeons. Bacteria naturally attach to these devices, increasing the risk for wound infection, which can result in non- or malunion, additional surgical procedures and extended hospital stays. Intramedullary nail surface properties can be modified to reduce bacterial colonisation and potentially infectious complications. In the current study, a coating combining a non-fouling property with leaching chlorhexidine for orthopaedic implantation was tested. Coating stability and chlorhexidine release were evaluated in vitro. Using a rat model of intramedullary fixation and infection, the effect of the coating on microbial colonisation and fracture healing was evaluated in vivo by quantitative microbiology, micro-computed tomography, plain radiography, three-point bending and/or histology. Low dose systemic cefazolin was administered to increase the similarities to clinical practice, without overshadowing the effect of the anti-infective coating. When introduced into a contaminated wound, the non-fouling chlorhexidine-coated implant reduced the overall bacteria colonisation within the bone and on the implant, reduced the osteolysis and increased the radiographic union, confirming its potential for reducing complications in wounds at high risk of infection.
    [Show full text]