Role of Povidone-Iodine in Reducing Surgical Site Infection

Purpose of Review

Surgical site infections (SSIs) are associated with significant morbidity and mortality. Given the role of endogenous carriage of Staphylococcus aureus, current patient decolonization strategies revolve around the application of topical antiseptic agents prior to and at the time of surgery.

Recent Findings

Intranasal single-application povidone-iodine (PVP-I) on the day of surgery is an emerging, attractive alternative to the established approach of a 5-day course of intranasal mupirocin for preoperative decolonization.

Summary

PVP-I appears more convenient and cost-effective for both patients and healthcare systems, and its role in reducing SSI is under investigation. However, most published literature consists of retrospective, single-center studies primarily done in orthopedic surgical populations. Based on current data, PVP-I appears to be as equally effective in SSI reduction as mupirocin, but larger and better-quality studies are needed to implement a change from currently established preoperative decontamination practices.