Complexing
iodine with
povidone (
polyvinylpyrrolidone) or
surfactants significantly limits the quantity of free
iodine. Reduction of the free
iodine level eliminates the adverse properties of staining, instability, and irritation and also alters bactericidal activity. Addition of
detergents to create surgical scrub solutions further reduces the activity of
iodine. In vitro testing indicated that the bactericidal activity of
iodophors was inferior to that of uncomplexed aqueous
iodine. In vivo tests proved that aqueous
iodine significantly potentiated the development of
infection. Although the
povidone iodophor did not enhance the rate of
wound or
infection, it offered no therapeutic benefit when compared with control
wounds treated with
saline solution. Addition of
detergents to the
povidone iodophor was deleterious, with the
wounds exposed to this combination displaying significantly higher
infection rates than untreated control
wounds. Based on these results, aqueous
iodine solutions and iodophor surgical scrub solutions should not be used on broken skin. Aqueous
iodophors can be used in
wounds, but no therapeutic benefit from such use was found in this study.