The efficacy and risks of using povidone-iodine irrigation to prevent surgical site infection: an evidence-based review.

quent but serious complication of surgery. Postoperative infection often requires repeat surgery and prolonged hospitalization, and it may compromise ultimate surgical outcomes. In addition to sterile procedures and patient warming, prophylactic antibiotics have been shown to reduce surgical site infection. Despite the widespread use of prophylactic antibiotics, however, surgical site infection continues to occur and is devastating for patients. Many different wound irrigation solutions, including soaps, antibiotics and antiseptics, have been used to reduce surgical site infection. Wound irrigation with povidone-iodine, an antiseptic solution, may be useful for reducing infection, but it is of uncertain efficacy and risk. Povidone-iodine (Betadine) is an antiseptic solution consisting of polyvinylpyrrolidone with water, iodide and 1% available iodine; it has bactericidal ability against a large array of pathogens. Although a vast amount of literature exists regarding its use as a topical antibacterical agent in surgery, its use as a prophylactic irrigation solution against surgical site infection has been examined to a lesser degree. This evidence-based review sought to determine the efficacy and risks of using povidone-iodine irrigation to prevent surgical site infection.