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Versatile Nature of Poly(Vinylpyrrolidone) in Clinical Medicine
Published in P. Mereena Luke, K. R. Dhanya, Didier Rouxel, Nandakumar Kalarikkal, Sabu Thomas, Advanced Studies in Experimental and Clinical Medicine, 2021
K. R. Dhanya, P. Mereena Luke, Sabu Thomas, Didier Rouxel, Nandakumar Kalarikkal
Poly(vinylpyrrolidone) is known to be polyvidone or povidone and it is depicted in the section of polymers of water-soluble as shown in Figure 4.1. In dry conditions, it can absorb moisture and in the solution state, exhibit fine wetting characteristics and can easily form films.
Povidone-Iodine
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Povidone-iodine (PVP-I) is a stable chemical complex of polyvinylpyrrolidone (povidone, PVP) and elemental iodine. Povidone-iodine directly causes in vivo protein denaturation and precipitation of bacteria resulting in the death of pathogenic microorganisms. It can kill viruses, bacteria, spores, fungi, and protozoa. Povidone-iodine aqueous solution has strong pharmacological activity against Staphylococcus aureus, Neisseria gonorrhoeae, Pseudomonas aeruginosa, Treponema pallidum, hepatitis B virus, HIV, and Trichomonas vaginalis. PVP-I is an effective and safe disinfectant agent. It has many applications in medicine: as a surgical scrub, in surgical drapes, in preoperative and postoperative skin cleansing, and for the treatment and prevention of infections in wounds and ulcers. For these purposes, povidone-iodine has been formulated at concentrations of 7.5-10.0% in various pharmaceutical forms including solution, ointment, dressing and scrub. Povidone-iodine is the most commonly used topical anti-infective agent worldwide because of its potent germicidal activity with relatively low irritancy and toxicity. A 10% PVP-I solution contains 1% releasable iodine, but only 0.001% free iodine, which is why PVP-I is less toxic and irritant than iodine, without being less antiseptic (1,35,42).
Scar Care after Surgical Treatment in Oncology Patients
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
The immature scar with a favorable evolution needs basic care: daily wound washing after 72 hours with soap and water and rigorous drying. During the first 2 weeks, it is recommended to avoid dehydration of the scar, avoid the appearance of scabs, and maintain a semiocclusive dressing. Transepidermal water loss is increased in hypertrophic scars and keloids. The subsequent dehydration of keratinocytes may stimulate the production of cytokines, leading to excessive collagen deposition by fibroblasts, which results in scar formation [9]. An example would be to keep a paper tape enriched in zinc from the immediate postoperative period until the fifth day. Dressings should lightly adhere to irregularly contoured, moist healing tissues and provide a continuous temporary artificial barrier [10]. There should be early removal of the stitches and placing of adhesive skin closures. The removal of foreign bodies, such as extruded stitches, is performed in a sterile condition, and when a skin continuity solution appears, it is recommended to initiate treatment with topical antibiotic ointment every 24 hours. Daily treatment with povidone-iodine solution should be avoided if the wound shows no signs of infection. It is recommended to avoid physical activity until 10–15 days, as well as bathtubs or spas.
Prevention and treatment of burn wound infections: the role of topical antimicrobials
Published in Expert Review of Anti-infective Therapy, 2022
Deepak K. Ozhathil, Steven E. Wolf
Though bacterial resistance is rare, resistant gram-negative strains have been reported. In 1980, four hospitals in New York State reported an outbreak of Pseudomonas cepacia that was attributed to contaminated 10% Povidone-Iodine solutions [88]. Povidone-iodine solutions are also painful with application and can cause hypersensitivity and contact dermatitis. Furthermore, iodine absorption across large wound surfaces can cause iodine toxicity-thyroid dysfunction (hyperthyroidism), acute renal failure, hypernatremia and metabolic acidosis. For this reason, it is avoided in patients with preexisting hyperthyroidism, renal dysfunction and dermatitis herpetiformis. Caution is recommended if an iodine allergy is present, and with use in children and women who are <32 weeks pregnant or lactating. In addition, because of drug interactions povidone-iodine should be avoided in patients on lithium, sulphafurazoles or sulphonylureas. Summary: Povidone-iodine is used as a pre-surgical scrub, however, due to its adverse effect profile, it is no longer commonly used outside of the operating theatre. Furthermore, it should be diluted at least ten-fold or more due to cytotoxicity, but it remains effective even at very low dilutions.
Endophthalmitis following Intravitreal Anti-Vascular Endothelial Growth Factor Therapy: Changes in Incidence and Outcomes over a 9-Year Period
Published in Current Eye Research, 2021
Maitri Pancholy, Philip P. Storey, Hannah J. Levin, Anthony Obeid, Samir N. Patel, Brandon Kuley, Jason Hsu, Marc J. Spirn, Mitchell Fineman, Michael A. Klufas, Omesh Gupta, Allen C. Ho, Sunir J. Garg
All IVIs were performed in an office-based setting. Eyes were prepared with topical or subconjunctival anesthetic followed by topical 5% povidone-iodine for at least 30 seconds prior to injection. There is a practice-wide protocol for preparing eyes for intravitreal injection; however, there are certain variables left to physician preference as detailed below. Povidone-iodine administration was repeated just prior to IVI at the discretion of the treating physician. Injection was performed with a 30-gauge needle for ranibizumab and aflibercept injection, or 31-gauge needle for bevacizumab injection, inserted 3.5–4 mm from the limbus. Based on physician preference, lid retraction was either achieved manually or with the use of a bladed lid speculum, with the majority of cases utilizing bimanual lid retraction. Conjunctival displacement prior to injection and quadrant of injection were determined by individual physician preference.
Viricidal treatments for prevention of coronavirus infection
Published in Pathogens and Global Health, 2020
Manoj Khokhar, Dipayan Roy, Purvi Purohit, Manu Goyal, Puneet Setia
Iodine and iodophors have been effective against a wide range of viruses, including CoVs and enteroviruses, polio, herpes, vaccinia, rabies, and tobacco mosaic viruses [49–51]. Povidone-iodine, a complex of polyvinylpyrrolidone and iodine, is routinely used in surgical procedures, and numerous studies have validated its safety. It showed rapid and effective viricidal activity against different types of HCoVs like SARS-CoVs (Isolate FFM-1 & Hanoi strain), and MERS-CoV (HCoV-EMC/2012), at concentrations of 0.23% to 7.5% with 15- and 60-second exposures, respectively [25,52,53]. Liang et al. characterized the viricidal activity of long-acting povidone-iodine gel formulations in the inactivation of SARS-CoV-2 in VERO76 cells in a time- and dose-dependent manner. Further, no toxicity was observed [54]. Povidone-iodine has also been recommended by UK investigators as nasal spray and mouthwash in health workers to prevent infection of the airways [55].