Randomized, controlled trial of povidone-iodine to reduce simple traumatic wound infections in the emergency department.

Abstract

Povidone Iodine (PVI) has been used to prevent wound infection for a long time, yet the merits and effectiveness of this agent in reducing the rates of infection in simple traumatic wounds have been debated. The aim of this study is determine the effect of PVI as skin disinfectant in preventing simple traumatic wound infection after repair in emergency departments. This study is a single-blind, randomized, controlled trial, conducted at the emergency departments of two university hospitals. In this trial, those collecting and analyzing data were unaware of the assigned treatment. Participants included ED patients with simple traumatic wounds, randomly assigned to either experiment or control groups. Wounds were similarly irrigated with normal saline in both groups. But the skin around the wounds of patients in the experiment group was cleansed by PVI solution. The patients were followed till their next ED visit for stitch removal. The presence or absence of wound infection was considered as the primary outcome and assessed by an ED physician. In total, 444 patients were screened and included in the study. The patients were statistically similar according to their baseline characteristics. Men constituted 85% of the study participants. The highest numbers of reported wound sites belonged to head (30%), lower limbs (24%) and upper limbs (19%) accordingly. The rates of infections in the experiment and control groups were similar (p=0.231) but a significant association was observed between the rate of infections and wound location. Lower limbs (OR=9.23, p<0.0001) and upper limbs (OR=5.47, p=0.011) indicated the highest risks of wound infections among other locations. Our study showed that using PVI in the management of traumatic wounds did not reduced rate of infections.