Diluted povidone-iodine irrigation prior to wound closure in primary and revision total joint arthroplasty of hip and knee: a review of the evidence

G. Cacciola, F. Mancino, M.A. Malahias, P.K. Sculco, G. Maccauro, I.De Martino

Article ID: 5709
Vol 34, Issue 3S2, 2020
DOI: https://doi.org/10.54517/jbrha5709
Received: 9 July 2020; Accepted: 9 July 2020; Available online: 9 July 2020; Issue release: 9 July 2020

Abstract

Periprosthetic Joint Infection (PJI) of the Hip and of the Knee is a tremendous complication associated with high patient morbidity, cost, and increased health care resource utilization. Over the last few years, several perioperative strategies have been developed in the hopes of reducing the risk of early superficial and deep surgical site infection (SSI). One of the most performed intraoperative treatments to reduce the risk of SSI in total joint arthroplasty is the use of dilute povidone-iodine (DPI) irrigation prior to wound closure. For this reason, we believed a systematic review of the literature was needed to better understand the current literature on the efficacy of dilute betadine in reducing PJI. The search terms for this systematic review was performed for keywords "betadine", "povidone-iodine", "lavage", "irrigation" and "arthroplasty". A total of six studies were included, four of these reported the outcome of primary total joint arthroplasty, and two of these reported the outcome of revision total joint arthroplasty. Some studies reported that the use of DPI is effective to reduce the incidence of infective complications, meanwhile other studies did not find differences when DPI was used. More studies must be addressed to provide the efficacy of DPI irrigation.


Keywords

betadine lavage;povidone-iodine lavage


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