The effect of wound irrigation with Povidone-Iodine

 

Outcome

 

Our congratulations go to Mr Matthew Newton Ede and his fellow researchers at the Universities of Birmingham and Manchester, whose ground-breaking study The effect of wound irrigation with Povidone-Iodine, funded by the BSRF, won the Whitecloud Award for Best Basic Science Paper 2016 at the Scoliosis Research Society meeting. The research also received the award for the Best Podium Presentation at the 2016 British Scoliosis Society meeting in Middlesbrough and has been published in Spine.

Mr Newton Ede and the team investigated the side-effects of a dilute iodine substance (known as PVI), which is used by many scoliosis surgeons to prevent wound infection. Results found that PVI has a rapid and detrimental effect on the cells which produce bone (osteoblasts). Osteoblasts are critical to the success of scoliosis fusion surgery as these are the cells which function to produce solid bony fusion.

It is hoped that the results of this study will help to inform practice regarding safe concentrations of PVI and exposure times.

 

Publication

Povidone-Iodine (PVI) has a Profound Effect on in vitro Osteoblast Proliferation and Metabolic Function and Inhibits Their Ability to Mineralise and form Bone.

Newton Ede MP , Philp AM, Philp A, Richardson SM , Mohammad S, Jones SW

Published in Spine Journal


 

Summary: The aims of this study were to:

  1. Determine the effects of dilute povidone iodine (PVI) on osteoblast function.
  2. Determine the effect of dilute PVI on disc cell function.
  3. Establish effects relative to concentration of PVI lavage.
  4. Establish effects relative to length of PVI exposure time.

Wound infection as a complication following scoliosis surgery and other spinal surgeries is potentially devastating and can lead to failure of the surgery and serious septic illness. This has lead to many surgeons using a dilute iodine lavage at the end of surgery (PVI).  PVI kills bacteria and is used as skin preparation. We do know that its use as a lavage in spinal wounds does lead to a reduced infection rate however, little is known about its side-effects when used in this way.

Critical to success of any scoliosis surgery is the establishment of solid bony fusion. This means that the spine, which is normally a mobile structure, must fuse solid along the length required. To do this the bone producing cells (osteoblasts) must be able to function normally to produce solid bony fusion. If this does not occur then further surgery is often required. Also it is desirable to not harm the intervertebral disc through surgery and cause premature degeneration, especially at the end of the fused segment where the spine is mobile. Thus the research team are examining, using animal tissue, the effect of dilute PVI on these bone and disc cells and these cells' ability to maintain their normal function and survivability after exposure. From this work we hope to describe the effect of dilute PVI lavage on these critical cells and inform practice regarding safe concentrations and exposure times.

Share this page