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Abstract
Background: The use of iodine is a controversial issue even though it has been used in wound management for over 150 years. There is a large amount of published literature available for both povidone and cadexomer iodine although the results are often conflicting due to the large array of different preparations used and different study types employed.
Objectives: This literature review concentrates on the use of povidone and cadexomer iodine. The review highlights their antimicrobial efficiency, the issue of bacterial resistance, and effects on tissue and cells involved in wound healing. Toxicity and adverse reactions associated with these antimicrobial agents are also considered.
Major findings: The literature supports the use of povidone and cadexomer iodine as effective antimicrobial agents that bacteria have not developed resistance to. Other findings noted that povidone and cadexomer iodine should be used with caution and at decreased concentrations in patients with extensive burns and systemic complications such as renal failure, thyroid dysfunction, and other severely immunocompromised patients.
Conclusions: The literature supports the use of povidone and cadexomer iodine in wound care for its effects on tissue and cells, especially in newer formulations. Cadexomer iodine has proven to be very effective in chronic wounds while povidone iodine has been noted to be more effective in infected acute wounds. Gaps in the research have been identified as a lack of clear evidence comparing new formulations of povidone iodine to traditional preparations. It is clear that more research evidence is required for clinicians who routinely use these antimicrobial agents in wound management.