de Jonge SW, et al. Systematic Review and Meta-Analysis of Randomized Controlled Trials Evaluating Prophylactic Intra-Operative Wound Irrigation for the Prevention of Surgical Site Infections. Surg Infect (Larchmt). 2017 May/Jun;18(4):508-519. Full-text for Emory users.
“Although recommendations from existing guidelines are conflicting [9,10] and recent well-designed RCTs are lacking, as many as 97% of surgeons irrigate wounds in an effort to reduce the risk of SSI [6,7]. The most commonly used irrigation solution is saline followed by aqueous PVP-I or antibiotic solutions [6,42,43]. The efficacy and clinical safety of irrigation with these solutions has been the subject of debate [11, 44]. Various concentrations of PVP-I are effective rapidly against a broad spectrum of pathogens, methicillin-resistant S. aureus (MRSA) included [45,46]. However, some in vitro studies [47-49] have reported a negative effect of PVP-I on tissue regeneration, and older case studies describe serum iodine toxicity as a result of irrigation [50-52]. However, these adverse effects could not be substantiated in clinical trials [29-35;41].” (p. 515)
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