Is skin disinfection with 10% povidone iodine sufficient to prevent epidural needle and catheter contamination?

Abstract

Epidural space infection is a potential complication of epidural catheter placement. In this study, we investigated the incidence of epidural needle and catheter contamination after skin surface disinfection with 10% povidone-iodine (PI). Sixty seven patients having surgery under epidural anesthesia were enrolled in this prospective study. After preparation with 10% PI, skin swab cultures were taken from the site of catheter insertion. Epidural needles were cultured immediately after epidural catheters were placed. Catheters were removed at 48 hours and 2 to 3 cm of the distal tips were cultured as well. Fifty-six skin swabs, 52 epidural needles, and 48 catheters were cultured. Although only 3.5% (2) colonization was observed on skin surface cultures, 34.6% (18) of the epidural needles and 45.8% (22) of the catheters were colonized. No systemic or local infection was observed. Our results suggest that despite skin surface disinfection with PI, there is still significant risk for contamination of needles and catheters during epidural catheterization.