Evaluation of Postoperative Povidone-Iodine in Adjustable Suture Strabismus Surgery to Reduce Suture Colonization A Randomized Clinical Trial

Evaluation of Postoperative Povidone-Iodine in Adjustable Suture Strabismus Surgery to Reduce Suture Colonization A Randomized Clinical Trial

Author Rossetto, Julia Dutra Autor UNIFESP Google Scholar
Suwannaraj, Sirinya Google Scholar
Cavuoto, Kara M. Google Scholar
Spierer, Oriel Google Scholar
Miller, Darlene Google Scholar
McKeown, Craig A. Google Scholar
Capo, Hilda Google Scholar
Abstract IMPORTANCE Although the association between suture colonization and postoperative infections remains hypothetical, measures to reduce perioperative suture colonization may minimize postoperative infections. The suture colonization rate in adjustable suture strabismus surgery is not well defined, and the effect of povidone-iodine use on suture colonization is unknown. OBJECTIVE To assess whether povidone-iodine application at the end of adjustable suture strabismus surgery decreases the suture colonization rate. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial designed in 2015 and performed from June 1 through October 31, 2015, a total of 65 adjustable and 43 control suture specimens from 65 demographically similar adults undergoing adjustable suture strabismus surgery were studied. A random sampling assigned participants into group 1 (with povidone-iodine) or group 2 (without povidone-iodine) at the end of surgery. A control suture specimen was obtained if ipsilateral nonadjustable surgery was performed. Both groups received antibiotic ointment at the end of the procedure. No patients refused participation or withdrew. Data analysis was performed from October 1 to December 31, 2015. Observers were unaware of patient grouping. INTERVENTIONS One drop of 5% povidone-iodine directly over the sliding noose of the adjustable suture at the end of surgery. MAIN OUTCOMES AND MEASURES The suture colonization rate after adjustment in group 1, group 2, and the control group. RESULTS Of 65 adults undergoing surgery, there were 17 men (49%) and 18 women (51%) in group 1 and 10 men (33%) and 20 women (67%) in group 2, as well as 20 men (47%) and 23 women (53%) in the control group. The mean (SD) age of the patients was 48.5 (16.8) years in group 1, 46.6 (18.1) years in group 2, and 47.7 (17.0) years in the control group. There was no difference in the colonization rate between group 1 (57%) and group 2 (47%) (relative risk [RR], 1.1

95% CI, 0.6-1.7

P = .80), group 1 and the control group (44%) (RR, 1.0

95% CI, 0.5-1.8

P > .99), or group 2 and the control group (RR, 1.3

95% CI, 0.8-2.1

P = .62). Eleven bacterial species were identified. Staphylococcus epidermidis was the predominant isolate (40 of 56 [71%]). A longer interval between the end of surgery and adjustment was associated with higher culture positivity (6.3 hours in positive vs 4.4 hours in negative cultures, P = .001)

however, there was no difference in bacterial growth between the groups. No adverse effects of povidone-iodine were observed. CONCLUSIONS AND RELEVANCE This study was not able to demonstrate that povidone-iodine at the end of adjustable suture strabismus surgery reduces the suture colonization rate.
xmlui.dri2xhtml.METS-1.0.item-coverage Chicago
Language English
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
National Institutes of Health (NIH)
Research to Prevent Blindness
Grant number NIH: P30EY014801
Date 2016
Published in Jama Ophthalmology. Chicago, v. 134, n. 10, p. 1151-1155, 2016.
ISSN 2168-6165 (Sherpa/Romeo, impact factor)
Publisher Amer Medical Assoc
Extent 1151-1155
Origin http://dx.doi.org/10.1001/jamaophthalmol.2016.2926
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000386486900019
URI https://repositorio.unifesp.br/handle/11600/56980

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