Combining Alginate/PVPI-Based Film with Frequency Rhythmic Electrical Modulation System (FREMS) Technology as an Advanced Strategy for Diabetic Wounds.

Diabetes is rising as one of the most diffused diseases of the century with the related urgent necessity to face its systemic and local effects on the patients, such as cardiovascular problems, degeneration of limbs, and dysfunction of the wound healing process. The diffusion of leg ulcers has been estimated to be 1.51 for 1000 population, and these non-resolved wounds can produce several social, economic, and mental health issues in diabetic patients. At the same time, these people experience neuropathic pain that causes morbidity and a further decrease in their quality of life. Here, a new study is presented where asodium alginate/Polyvinylpyrrolidone-Iodine complex (PVPI)-based wound dressing is combined with the Frequency Rhythmic Electrical Modulation System (FREMS) technology, an established medical device for the treatment of neuropathic pain and diabetic ulcers. The produced Alginate/PVPI-based films are characterized in terms of morphology, chemistry, wettability, bio-/hemo-compatibility, and clotting capacity. Next, the Alginate/PVPI-based films are used together with FREMS technology in diabetic mice models, and synergism of their action in the wound closure rate and anti-inflammatory properties is found. Hence, how the combination of electrical neurostimulation devices and advanced wound dressings can be a new approach to improve chronic wound treatment is demonstrated.

Quaternary ammonium N,N,N-trimethyl chitosan derivative and povidone­iodine complex as a potent antiseptic with enhanced wound healing property.

The importance of developing more potent antimicrobials and robust infection prevention practices has been highlighted recently with the increase in reports of emerging bacterial resistance mechanisms and the development of antibiotic-resistant microbes. In this study, a quaternary ammonium chitosan derivative, N,N,N-trimethyl chitosan chloride (TMC) with inherent bactericidal property was synthesized and complexed with povidone­iodine (PVP-I) to create a potentially more potent antiseptic solution that could also significantly enhance the wound healing process. TMC, a positively charged, water-soluble derivative of chitosan, formed stable solutions with PVP-I at 5% w/v TMC concentration (TMC5/PVP-I). TMC5/PVP-I was significantly effective against multidrug-resistant bacteria S. aureus compared with PVP-I alone. TMC/PVP-I solutions also showed fungicidal property against C. albicans, with no cytotoxic effects when tested against human fibroblast cells cultured in vitro. Wound healing assessment in vivo revealed early collagen formation and re-epithelialization for TMC5/PVP-I treated wounds in rats relative to control and PVP-I only. Formulation of TMC/PVP-I solutions presented in the study can be easily adapted in the existing production of commercial PVP-I creating a new product with more potent bactericidal and enhanced wound healing properties for optimal wound care.

A novel bimetallic (Fe/Bi)-povidone-iodine micro-flowers composite for photocatalytic and antibacterial applications.

The present work describes the synthesis of polyvinylpyrrolidone (PVP) assisted Fe-BiOI based Fe/Bi-povidone­iodine (Fe/Bi-P-I) micro-flowers based composite and its photocatalytic and antibacterial applications. The Fe/Bi-P-I micro-flowers-based composite material was synthesized using a simple co-precipitation method. The prepared Fe/Bi-P-I micro-flowers-based composite materials were characterized using various characterization techniques and tested against photocatalytic degradation of rhodamine B (RhB) dye and antibacterial analysis. The PVP or povidone­iodine provides more exposure of reactive sites and oxygen vacancies, which leads to a high separation rate of photoinduced charge carriers, and migration, thereby 100% of photodegradation efficiency at 1 mg/L initial concentration of RhB dye towards the synthesized P-Fe-BiOI based micro-flowers composite. Interestingly, Povidone-Iodine in Fe/Bi-P-I micro-flowers-based composite might be advantageous for antimicrobial activity against both gram-negative (E. coli), and gram-positive (S. aureus) bacterial strains. Therefore, the prepared Fe/Bi-P-I micro-flowers-based composite improved both photocatalytic degradation of organic pollutants as well as high antimicrobial activity. The method of synthesizing the Bi/Fe-P-I micro flower composite in the present study is novel, facile, and economically viable.

Formulation Development of Topical Preparation Containing Nanoparticles of Povidone-Iodine for Wound Healing.

Povidone-iodine (PVI) is an antiseptic drug that is used for wound healing or for repair of the damaged tissue. Studies on solid lipid nanoparticles (SLNs) indicate that this system could potentially be used as a delivery system with improved drug entrapment efficiency and controlled drug release for hydrophilic actives. This study focuses on developing a topical gel containing SLNs of PVI for wound healing. SLNs were prepared by using the solvent emulsification diffusion method. Lipids such as glycerol monostearate, palmitic acid, and stearic acid, and surfactants such as polysorbate 80, soyalecithin, and Pluronic F-68 were used for the preparation of SLN. These were screened out based on particle size and entrapment efficiency of SLN. Gel was prepared by using Carbopol 940 (1% w/w) and propylene glycol (10% w/w). Formulated SLNs were evaluated by various in vitro and in vivo techniques. Based on the results, the drug-to-lipid ratio (1:3) and 2% polysorbate 80 (surfactant) along with stirring rate (3,000 rpm) produced the desired particle size (285.4 nm) with good stability. 22.85% drug loading and 88.83% drug entrapment efficiency were found in the optimized formulation. In vitro drug release shows that it follows the Korsmeyer-Peppas model. The animal study shows that the period of epithelization produced by the test group was 17.14 ± 1.35 days, which was near to that of the standard group (16.25 ± 1.24 days). Clinical Trial Registration number: 1044/PO/Re/S/07/CPCSEA.

Poly (vinylpyrrolidone)­iodine engineered poly (ε-caprolactone) nanofibers as potential wound dressing materials.

Facilitating the process of wound healing and effective treatment of wounds remains a serious challenge in healthcare. Wound dressing materials play a major role in the protection of wounds and in accelerating the natural healing process. In the present study, novel core/shell (c/s) nanofibrous mats of poly(vinyl pyrrolidone)­iodine (PVPI) and polycaprolactone (PCL) were fabricated using a co-axial electrospinning process followed by their surface modification with poly-l-lysine. The developed nanofibrous mats were extensively characterized for their physicochemical properties using various analytical techniques. The core/shell structure of the PVP-I/PCL nanofibers was confirmed using TEM analysis. The PVP-I release studies showed an initial burst phase followed by a sustained release pattern of PVP-I over a period of 30 days. The developed nanofibers exhibited higher BSA and fibrinogen adsorption as compared to pristine PCL. Cytotoxicity studies using MTT assay demonstrated that the PVP-I/PCL (c/s) nanofibers were cytocompatible at optimized PVP-I concentration (3 wt%). The PCL-poly-l-lysine and PVP-I/PCL-poly-l-lysine nanofibers exhibited higher cell viability (24.2% and 21.4% higher at day 7) when compared to uncoated PCL and PVP-I/PCL nanofibers. The PVP-I/PCL nanofibers showed excellent antimicrobial activity against both Gram-positive (S. aureus) and Gram-negative (E. coli) bacteria. The inflammatory response of Mouse RAW 264.7 macrophage cells towards the nanofibers was studied using RT-PCR. It revealed that the pro-inflammatory cytokines (TNF-α and IL-1ß) were significantly upregulated on PCL nanofibers, while their expression was comparatively lower on poly-l-lysine coated PCL or PVP-I/PCL(c/s) nanofibers. Overall, the study highlights the ability of poly-l-lysine coated PVP-I/PCL (c/s) nanofibers as potential wound dressing materials effectively facilitating the early stage wound healing and repair process by virtue of their selective modulation of inflammation, cell adhesion and antimicrobial properties.

Dental floss impregnated with povidone-iodine coated with Eudragit L-100 as an antimicrobial delivery system against periodontal-associated pathogens.

Introduction. Periodontitis is among the most widespread oral bacterial diseases affecting 15-20% of the world population.Aim. This study aimed to develop dental floss impregnated with povidone-iodine (PVP-I) as an antimicrobial delivery system against periodontopathogenic bacteria in a planktonic form and within biofilms.Methods. Identical lengths of dental floss impregnated with PVP-I formulations were placed on agar along with previously grown periodontal pathogens. The bioactivity of the dental floss was investigated by response-surface methodology. In order to explore the antibacterial activity of the selected formulation and the potential application in the prevention and treatment of plaque-caused diseases such as periodontitis and caries, the antibacterial and anti-biofilm activity of the selected PVP-I formulation against pathogenic bacteria were investigated.Results. The results indicated that the coating formulation containing Eudragit L-100 2.90 %, PVP-I 24.58 % and PEG 400 3.73 % had antimicrobial activity for all pathogens. The mechanism of this formulation involved disruption of bacterial cell membranes. Moreover, this formulation inhibited the formation of oral pathogenic biofilms.Conclusion. It was concluded that Eudragit L-100 and PVP-I-coated dental floss represented a potential therapeutic agent to prevent periodontal diseases and dental caries and exhibited non-toxicity to periodontal ligament cells.

Povidone-iodine-functionalized fluorinated copolymers with dual-functional antibacterial and antifouling activities.

Biomaterial-associated infections caused by bacterial contamination and the subsequent formation of biofilms on the surfaces are challenges faced by our healthcare system. In this work, povidone-iodine-functionalized fluorinated copolymers with stable antibacterial, antibiofilm, and antifouling activities were designed and prepared by a two-step synthesis. First, a series of poly(hexafluorobutyl methacrylate-co-N-vinyl-2-pyrrolidone), i.e., P(HFBMA-NVP), were synthesized by radical copolymerization at different feed ratios to acquire water insoluble and antifouling copolymers. At the second step, the NVP segments in the copolymer were complexed with iodine to obtain the objective antibacterial and antifouling copolymer P(HFBMA-NVP)-I. The chemical and physical characteristics of the copolymers were investigated using 1H NMR, FTIR, XPS, EDX, UV-Vis, SEM, TEM, elemental analysis, and contact angle measurement. P(HFBMA-NVP)-I exhibited excellent antibacterial activity against both Gram-negative bacteria (Escherichia coli) and Gram-positive bacteria (Staphylococcus aureus), as well as good biocompatibility towards human hepatocyte cells (L02) and Caenorhabditis elegans. Using the electrospinning or spraying technique, P(HFBMA-NVP)-I was coated on polystyrene slides, medical stainless steel sheets, and cotton fabric, allowing the surfaces to have stable antibacterial and antibiofilm activities against pathogenic bacteria and antifouling capability against foulants and blood, and exhibit excellent self-cleaning properties.

The effect of diluting povidone-iodine on bacterial growth associated with speech.

BACKGROUND: Povidone-Iodine (PI) may be diluted when used as an antiseptic prior to an intravitreal injection in an attempt to decrease patient discomfort. This study aims to investigate the effect of diluting povidone-iodine (PI) on bacterial growth from bacterial droplet dispersal associated with speech. METHODS: Participants read a standardised script for 5 min over a blood agar plate positioned at 20 cm in a simulated position of an intravitreal injection procedure. The blood agar plates were subject to a randomised pre-application of 1% PI; 2.5% PI; 5% PI and no pre-application (control). The plates were incubated at 37 °C for 72 h and the number of Colony Forming Units (CFUs) was determined. CFUs were summarised as median and interquartile range (IQR). Wilcoxon rank sum test was used to assess pairwise comparisons of the various PI concentrations to the control group. Any trend across PI concentration was assessed using Kendall's tau rank correlation. RESULTS: Twenty-one subjects participated. Control plates had a median growth of 25 CFUs (interquartile range [IQR]:15-40), 1% PI plates had a median growth of 30 CFUs (IQR:15-82), 2.5% PI had a median growth of 18 CFUs (IQR:10-32) and 5% PI had a median growth of 2 CFUs (IQR:0-5). There was significantly less bacterial growth with 5% PI compared to control (P < 0.001). Bacterial growth at 2.5% PI and 1% PI did not differ significantly from control. There was a statistically significant trend for decreasing colony count as PI concentration increased (P < 0.001). CONCLUSIONS: PI concentrations less than 5% are not effective at reducing bacterial growth from bacterial droplet dispersal associated with speech. When using PI for pre-injection antisepsis, concentrations below 5% should be avoided.

Hyaluronic Acid-Povidone-Iodine Compound Facilitates Diabetic Wound Healing in a Streptozotocin-Induced Diabetes Rodent Model.

BACKGROUND: This study investigated whether a hyaluronic acid-povidone-iodine compound can enhance diabetic wound healing. METHODS: A dorsal skin defect (6 × 5 cm) in a streptozotocin-induced diabetes rodent model was used. Seventy male Wistar rats were divided into seven groups: I, normal control; II, diabetic control, no treatment; III, diabetic rats, lower molecular weight (100 kDa) hyaluronic acid; IV, rats, higher molecular weight (1000 kDa) hyaluronic acid; V, rats, 0.1% povidone-iodine; VI, rats, lower molecular weight hyaluronic acid plus povidone-iodine; and VII, rats, higher molecular weight hyaluronic acid plus povidone-iodine. Histologic examination was performed with hematoxylin and eosin staining. CD45, Ki-67, prolyl 4-hydroxylase, and vascular endothelial growth factor were evaluated with immunohistochemical staining. RESULTS: Compared with the control, higher molecular weight hyaluronic acid plus povidone-iodine-treated rats had significantly reduced wound area (p < 0.001). Higher molecular weight hyaluronic acid plus povidone-iodine increased wound healing time when compared with higher molecular weight hyaluronic acid, povidone-iodine, or lower molecular weight hyaluronic acid plus povidone-iodine. Histology revealed significantly increased neovessels and suppressed inflammatory response in the higher molecular weight hyaluronic acid plus povidone-iodine group when compared with the control group. Immunohistochemical staining revealed significantly increased Ki67, prolyl 4-hydroxylase, and vascular endothelial growth factor expression, and suppressed CD45 expression in the higher molecular weight hyaluronic acid plus povidone-iodine group when compared with the other groups. CONCLUSION: Higher molecular weight hyaluronic acid plus povidone-iodine complex dressing significantly facilitated diabetic wound healing via increasing neovascularization and tissue regeneration and suppressing a proinflammatory response.

Potentiometric characterization of iodine-based disinfecting preparations.

A potentiometric method is presented that allows to characterize aqueous iodine-based disinfecting solutions and preparations, respectively. By means of three electrodes (iodide-sensitive, platinum redox, and reference electrode), the concentrations of free iodine, iodide, and triiodide were determined. The apposition "free" means iodine not complexed with ligands originating from the organic matrix of the iodophoric iodine source (e.g. povidone iodine). Based on the gained values ([I2], [I-], and[I3-]), it is possible to assess features concerning kinetics of disinfection, disinfecting capacity, and tolerability. The method distinguishes by simplicity and modest time expenditure of 10-15 min for a complete investigation comprising two potentiometric measurements.

Influence of povidone-iodine on micro-tensile bonding strength to dentin under simulated pulpal pressure.

BACKGROUND: Previous studies had reported that bond strength deteriorate over time following the dentin surface pretreatment with chlorhexidine. Therefore, further investigations are needed to evaluate the effect of other materials such as povidone iodine. The purpose of this study was to investigate the effects of 10% povidone-iodine pretreatment on the resin-dentin micro-tensile bond strength of a single bond adhesive system in permanent teeth over time, and compare it with 2% chlorhexidine. METHODS: Flat dentin surfaces were prepared in 63 extracted permanent teeth. Teeth were randomly assigned to a 10% povidone-iodine pretreatment, a 2% chlorhexidine pretreatment, or a control group. Composite resin blocks were built up over treated surfaces under pulp pressure simulation. The prepared specimens were assigned to three storage time, 24 h, 1 week, and 2 months. Samples were vertically sectioned to obtain specimens of 0.7 to 1.2 mm2 cross-sectional area. RESULTS: No significant reduction of bond strength of povidone iodine group was found among the three storage times (p = 0.477). A significant reduction of bond strength for both chlorhexidine and control groups was found in the three storage times (p <  0.001). CONCLUSION: Povidone iodine pretreatment of etched dentin was effective in reducing the loss of bond strength over time, while the chlorhexidine pretreatment and negative control showed significant deterioration in micro-tensile bond strength over time in permanent teeth.

Chitosan nanoparticles and povidone iodine containing alginate gel for prevention and treatment of orthopedic implant associated infections.

Orthopedic Implant associated infections (OIAIs) are the most serious complications in the orthopedic surgery. Such complications are of major concern unless encountered during initial stages of contamination due to the bacterial biofilm formation. Thus, our aim is to eradicate bacteria at the early stages of infection. Herein, we develop a vancomycin-loaded chitosan nanoparticles (CNPs) and povidone-iodine (PI) containing in situ alginate (CNPs-PI-Alg) gel for antibacterial and antibiofilm activity, respectively. The CNPs were synthesized by ionic gelation method and the processing parameters were optimized to attain nanoparticles of 200-250 nm size and 37.13 ±â€¯3.18 mV charge. A PI-loaded in situ alginate (PI-Alg) gel served as a carrier wherein, the CNPs were incorporated to attain sustained release of an antibacterial agent. The CNPs-PI-Alg gel showed more stability and mechanical properties compared to the Blank-Alg gel. The CNPs-PI-Alg gel exhibited sustained release of vancomycin and PI over a period of 10-15 days. The hemolysis and cytocompatibility studies demonstrated the safety and biocompatibility of CNPs-PI-Alg gel. Furthermore, significant antibacterial and antibiofilm effect against Staphylococcus aureus showed that the CNPs-PI-Alg in situ gel has a potential for the prevention of OIAIs.

A biocompatible sodium alginate/povidone iodine film enhances wound healing.

In the last few years, there has been an increasing tendency to use natural polymers for the fabrication of dressings for wound and burn management. Among them, alginate, a polysaccharide extracted primarily from marine algae, exhibits attractive properties being non-toxic, hydrophilic and biodegradable. The aim of this study was to characterize the in vitro biocompatibility and the efficacy of a composite polymeric material based on sodium alginate (NaAlg) and povidone iodine (PVPI) complex in a mouse model of wound healing. The developed material combines the excellent wound healing properties of alginates with the bactericidal and fungicidal properties of PVPI, providing a controlled antiseptic release. We demonstrated that the NaAlg/PVPI films are able to reduce the inflammatory response both in human foreskin fibroblasts after lipopolysaccharide (LPS) stimulus and in rodents after wound induction. Furthermore, the NaAlg/PVPI film-treated animals showed a significantly higher wound closure compared to untreated animals at each time point considered. Interestingly, the complete wound closure was achieved within 12 days only in the film-treated group, indicating that the full-thickness wounds healed more rapidly in these animals. The results demonstrate that the NaAlg/PVPI films are biocompatible and possess healing properties that accelerate the wound closure.

Povidone-Iodine-Based Polymeric Nanoparticles for Antibacterial Applications.

As microbial contamination is becoming more and more serious, antibacterial agents play an important role in preventing and removing bacterial pathogens from microbial pollution in our daily life. To solve the issues with water solubility and antibacterial stability of PVP-I2 (povidone-iodine) as a strong antibacterial agent, we successfully obtain hydrophobic povidone-iodine nanoparticles (povidone-iodine NPs) by a two-step method related to the advantage of nanotechnology. First, the synthesis of poly(N-vinyl-2-pyrrolidone-co-methyl methacrylate) nanoparticles, i.e., P(NVP-MMA) NPs, was controlled by tuning a feed ratio of NVP to MMA. Then, the products P(NVP-MMA) NPs were allowed to undergo a complexation reaction with iodine, resulting in the formation of a water-insoluble antibacterial material, povidone-iodine NPs. It is found that the feed ratio of NVP to MMA has an active effect on morphology, chemical composition, molecular weight, and hydrophilic-hydrophobic properties of the P(NVP-MMA) copolymer after some technologies, such as SEM, DLS, elemental analysis, 1H NMR, GPC, and the contact angle test, were used in the characterizations. The antibacterial property of povidone-iodine NPs was investigated by using Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Pseudomonas aeruginosa (P. aeruginosa) as model bacteria with the colony count method. Interestingly, three products, such as glue, ink, and dye, after the incorporation of povidone-iodine NPs, show significant antibacterial properties. It is believed that, with the advantage of nanoscale morphology, the final povidone-iodine NPs should have great potential for utilization in various fields where antifouling and antibacterial properties are highly required.

Quantitative analysis of povidone-iodine thin films by X-ray photoelectron spectroscopy and their physicochemical properties.

In this study, povidone-iodine (PVP-I) has been formulated as a topical spray to produce a thin film for the controlled release of I2. By means of experimental design, 27 formulations containing glycerol, ethanol, PEG 400, copovidone and HFA 134a as a propellant were prepared. The pH values of all formulations were in the range of 6-7. The viscosity was within the range of 11.9-85.9 mPa s. The surface tensions were 20.3 to 24.6 mN m-1 and the contact angles were between 19.3 and 38.7°. The assays for the iodine contents were within acceptable range (80-120 %). X-ray photoelectron spectroscopy analysis revealed the ionized form of iodine was much higher than the unionized form. The MIC and MBC values of the PVP-I sprays against Staphylococcus aureus, S. epidermidis and Pseudomonas aeruginosa were higher than that of commercial PVP-I solution. The cytotoxicity study confirmed that the PVP-I spray had lower toxic effects on keratinocytes and fibroblasts compared to the commercial PVP-I solution. The formulation containing 59 % ethanol, 18 % copovidone and 12 % PEG 400 showed good antibacterial activity.

Relationship between Virucidal Efficacy and Free Iodine Concentration of Povidone-Iodine in Buffer Solution.

Povidone-iodine solutions prepared to various concentrations (0.01, 0.1, 1 and 10%) with 0.2M phosphate buffer (pH 7.0) (PVP-I PB) were analyzed to determine their free iodine concentrations using membrane permeation cells, and their inactivation effects on three viruses (influenza A virus, poliovirus type 1 and adenovirus type 3) were examined. The free iodine concentrations in the 0.01-10% PVP-I PB were determined to be 1.84, 4.88, 1.58 and 0.17 ppm (approximate values), respectively, with the maximum obtained for the 0.1% solution. The virucidal efficacy of these PVP-I PB against poliovirus type 1 and adenovirus type 3 was found to be generally dependent on free iodine concentration, with the 0.1% solution being the most effective. Influenza A virus was inactivated with an action time of 15 s at all four concentrations examined. The results of this study suggested an association between free iodine concentration and virucidal efficacy for the 0.01-10% PVP-I PB.

Effect of pirfenidone delivered using layer-by-layer thin film on excisional wound healing.

The aim of this study was to evaluate the effect of a new anti-fibrotic agent, pirfenidone (PFD), delivered using polyelectrolyte multilayer films on excisional wound healing. Polyelectrolyte multilayer films were prepared by layer-by-layer (LbL) sequential adsorption of chitosan and sodium alginate. The UV-spectrophotometer, FTIR and differential scanning calorimeter were used to characterize the LbL thin films. The PFD was entrapped within the LbL thin films and its effect on excisional wound healing was studied in C57BL/6. The total protein, collagen content and TGF-ß expression within the wound tissue were determined after application of PFD using LbL thin films, chitosan hydrogel and polyethylene glycol hydrogel. UV-spectrophotometer and FTIR studies showed a sequential adsorption of chitosan and alginate polymer layers to form LbL thin films. The thickness of LbL thin films with 15 bilayers was found to be 15 ± 2 µm. HPLC analysis showed a PFD loading efficiency of 1.0 ± 0.1mg in 1cm(2) area of LbL thin film. In vivo wound healing studies in C57BL/6 mice showed an accelerated (<9 days) wound contraction after treatment with the PFD compared with blank LbL thin film and commercial povidone-iodine gel (12 days). The collagen content within the wound tissue was significantly (p<0.05) less after treatment with PFD compared with blank film application. Western blot analysis showed gradual decrease in TGF-ß expression within the wound tissue after treatment with PFD. This study for the first time demonstrated that new anti-fibrotic agent PFD loaded in LbL thin films can be utilized for excisional wound healing.

Foaming Betadine Spray as a potential agent for non-labor-intensive preoperative surgical site preparation.

BACKGROUND: The Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) report published in 2009 shows that there were about 16,000 cases of surgical site infection (SSI) following ~ 850,000 operative procedures making SSI one of the most predominant infection amongst nosocomial infections. Preoperative skin preparation is a standard procedure utilized to prevent SSIs thereby improving patient outcomes and controlling associated healthcare costs. Multiple techniques/ products have been used for pre-operative skin preparation, like 2 step scrubbing and painting, 2 step scrubbing and drying, and 1 step painting with a drying time. However, currently used products require strict, time consuming and labor-intensive protocols that involve repeated mechanical scrubbing. It can be speculated that a product requiring a more facile protocol will increase compliance, thus promoting a reduction in SSIs. Hence, the antimicrobial efficacy of a spray-on foaming formulation containing Betadine (povidone-iodine aerosol foam) that can be administered with minimum effort is compared to that of an existing formulation/technique (Wet Skin Scrub). METHODS: In vitro antimicrobial activities of (a) 5% Betadine delivered in aerosolized foam, (b) Wet Skin Scrub Prep Tray and (c) liquid Betadine are tested against three clinically representative microorganisms (S. aureus, S. epidermidis and P. aeruginosa,) on two surfaces (agar-gel on petri-dish and porcine skin). The log reduction/growth of the bacteria in each case is noted and ANOVA statistical analysis is used to establish the effectiveness of the antimicrobial agents, and compare their relative efficacies. RESULTS: With agar gel as the substrate, no growth of bacteria is observed for all the three formulations. With porcine skin as the substrate, the spray-on foam's performance was not statistically different from that of the Wet Skin Scrub Prep technique for the microorganisms tested. CONCLUSIONS: The povidone-iodine aerosolized foam could potentially serve as a non-labor intensive antimicrobial agent for surgical site preparation.

Preoperative skin antiseptics for prevention of cardiac implantable electronic device infections: a historical-controlled interventional trial comparing aqueous against alcoholic povidone-iodine solutions.

AIMS: Local skin antiseptic prevention against cardiac implantable electronic device (CIED) infections is not yet fully understood. This monocentre historical-controlled study sought to (i) conduct a prospective observational analysis comparing two antiseptic skin preparations over two similar consecutive periods of time, one conducted over a 1-year period using an aqueous povidone-iodine solution (Group I) and the other over the following with an alcoholic povidone-iodine solution (Group II); (ii) determine the predictive factors of CIED infection. METHODS AND RESULTS: Cardiac implantable electronic device implantation was performed in 1326 patients (pts). A total of 32 pts (2.4%) developed a CIED infection. Long-term follow-up (26 ± 3 months) revealed no significant difference between the groups: infections were observed in 14 of the 648 pts (2.2%) in Group I vs. 18 of the 678 pts (2.7%) in Group II (P = 0.9). Single- and multiple-variable logistic regression analyses were performed to identify risk factors; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. The occurrence of infection was positively correlated with re-intervention (aOR, 7.16; 95% CI, 2.56-19.99; P < 0.0001), number of generator replacements, mean (aOR, 3.47; 95% CI, 2.22-5.44; P < 0.001), and haematoma (aOR, 48.4; 95% CI, 13.45-174.25; P < 0.0001). CONCLUSION: This study found that aqueous and alcoholic povidone-iodine solutions displayed similar antiseptic effects regarding CIED infection prevention. Independent predictive factors of CIED infection were re-intervention, haematoma, and number of generator replacements.

Effect of different chemical disinfectants on color stability of acrylic denture teeth.

PURPOSE: The purpose of this study was to evaluate the effects of chemical disinfectants on the color stability of acrylic denture teeth (ADT) via spectrophotometric analysis. MATERIALS AND METHODS: A total of 120 central ADT specimens were randomly assigned to eight experimental groups and immersed in the following solutions (n = 15). Tap water/control group (CON), neutral soap (NTS), 2% sodium hypochlorite (SHC1), 5.25% sodium hypochlorite (SHC2), sodium perborate (SPB), povidone-iodine (PVI), chlorhexidine gluconate (CHG), and glutaraldehyde (GTA). Color measurements of teeth were performed by spectrophotometry after 10, 30, 48, 72, 144, and 960 immersion cycles in each tested solution. Color differences (ΔE*) were then evaluated using the Commission Internationale D'Eclairage (CIE) L*a* b* color system. Furthermore, Kruskal-Wallis, Mann-Whitney U, and Friedman comparison tests (α = 0.05) were performed on all data. RESULTS: There were significant differences in ΔE* values (p < 0.05) among the eight experimental groups. In addition, the highest ∆E* values were obtained in group SHC2, followed, respectively, by the SHC1, CHG, SPB, PVI, NTS, and CON groups. CONCLUSION: All the chemical disinfectants used in the study affected the color values of ADTs. Furthermore, ΔE* values increased along with the number of immersion cycles and total immersion time.