Getting together a FAK, I found the following article while researching antiseptics: "Effect of povidone-iodine on wound healing: a review" "The varied studies provide evidence that in most instances, povidone-iodine did not effectively promote good wound healing; in fact, most studies showed either impaired wound healing, reduced wound strength, or infection." So I guess this means in many cases simply cleaning the wound sufficiently is equally, if not more effective. Any thoughts? Suggestions for a better alternative?
Some use Saline Solution instead. I'm no expert in this though. I've been reading a lot of this type of stuff lately. Been working on about 3 different first aid kits.
Saline is great, I used it for post surgical wound care last year and I was amazed. Of course nothing beats good old isopropyl alcohol, the burn means its working!! Also bear in mind that something like 10% of the population is allergic to povidone-iodine as well, so if you kits are for the general public I suggest forgoing it.
I have heard the same thing a few times - specifically in the wilderness medicine arena. I would Definetly recommend saline or at least clean water - copious amounts or either one is ideal. Ninja Medic (mel)
I love evidence base practice. The problem with providine ,alcohol, or other disinfectants or anti microbial agents is that , while it is toxic to bacteria it is also harmful to new cells. The new cells are required for wound regeneration and to promote healing. Normal saline or clean ( potable) soapy water
If you are out in the field then normal saline or clean water and a bit of gauze to get the crud out of the would then cover it with a clean dressing. If at home then I usually just have a shower and let the water spray clean the wound (this works very well) then let the area dry and cover with an appropriate dressing. When I was working as an event medic the medical panel that reviewed the organizations medical protocols each year, banned the use of any creams, liquids or ointments that were not normal saline for cleaning wounds across the entire nation wide organization. There are several studies that show that using any disinfectants on a wound can actually dramatically affect the healing time and greatly increase the risk and amount of scarring. So not I would not recommend using anything except for normal saline, a piece of gauze and hands on cleaning of a wound. Edit: Remember kids, don't sleep & type a post.
Interesting. I know I was still betadined the last time they felt the need to cut into me. My question would be if I can still keep it as a means of water purification for wilderness care (flushing a wound only, not drinking -- yuck!) when clean water isn't available? Lightweight, inexpensive, long shelf-life, the major issue is the amount of time it takes. Still kills E. Coli though, doesn't it? (edit: just a reminder: no iodine, even further diluted such as to sterilize water, for patients with an allergy to it, any type of thyroid issue, or who are pregnant)
Copious amounts of water for wound irrigation, if it's really contaminated add betadine to the water, u should avoid using betadine, iodine, or peroxide straight it kills your cells just the same as it kills the bacteria
That's good intel. I have both the Povidone Iodine wipe and the ones on a stick on my truck, but I've personally never used it. My go-to is Normal Saline flush. If I don't have access to that, I just use clean water (bottled preferably).
Hey CA4L Did you find the whole article online? When I searched for your term I was only able to pull up the abstract. There are conflicting literature surveys as well ie woundsinternational.com/made-easys/iodine-made-easy/page-4 In my personal use (which is for all intents and purposes, unscientific and therefore unsupportable ), povidone iodine is my goto for all cuts and scrapes. I find it far more effective than the OTC triple anti-biotic creams which in my experience goop things up needlessly and significantly slow scab formation and skinning over. I did not realize that there are significant allergy issues, which I can certainly see as a problem in a general use FAK. But I'll need some solid and convincing science to pry it out of my warm, wet, blood soaked, personal boo-book kit Cheers, Ted
I did not see the full article online. It is worth noting however, that the study is not a singular trial, but a meta-analysis of (at the time) modern clinical trials appearing in a peer-reviewed journal, and the article is hosted by the NIH. Such credentials don't automatically make an article the be-all end-all final word on a subject, but they are pretty solid nonetheless.
connect.jbiconnectplus.org/ViewSourceFile.aspx?0=4341 try this article it has some stats. and comparisons Xiii
emedicine.medscape.com/article/1895071-overview, this article pretty much the same but some use for anti microbials
I'm wary of literature reviews, I tend to think of them as the "editorial" of the science world, usually authored by young scientists who are marking time while they sufficiently develop their grant writing skills. And, to be brutally honest, my science background is straight chemistry and physics, which biases me towards liking the full frontal attack of a non-specific inorganic salt over the slightly more nuanced trickery of a biochemical antibiotic But... I hate getting tied up by my own ill-informed opinions, so now I must search out and read more Thanks, Ted
These are not the only articles, I did a paper towards my masters and there are hundreds of studies done in over 50 countries that come up with the same results. I think you will find that review done by dressing companies or pharmacutical companies may have to be taken with a pinch of salt. but the studies and reviews done by nursing organisations, NGOs or some non affiliated universities tend to be more relliable. but i really think that the fact that the overwhelming evidence does not recomend anything but potable water, soapy water or normal saline; unless the wound has excess exudate that indicates purelent infection. personally I think providine or iodine for a first wash will not harm to much as long as person has no allergies to iodine.Then again if it has worked for you then who am I or any body else to tell you what to do. Xiii
I think the prevailing estamate is that about 8-11% have some form of allergy to iodine from mild to severe.
