Wound Cleansing with Povidone-Iodine

General Principles for Wound Cleansing

The American Heart Association recommends that superficial wounds and abrasions should be thoroughly irrigated until there is no obvious debris or foreign matter in the wound 1
Running tap water or sterile saline solutions are preferred for most wound irrigation rather than antiseptic agents like povidone-iodine, as recommended by the American Heart Association 1, 2
Clean superficial wounds and abrasions should be covered with an occlusive dressing to promote wound healing, according to the American Heart Association 1
Infection rates of wounds irrigated with tap water are similar to infection rates of wounds irrigated with sterile saline solution, as found by the American Heart Association 1

Heavily contaminated wounds may be considered for povidone-iodine use, especially if there is significant contamination with soil or other foreign material, as suggested by the World Journal of Emergency Surgery 3, 4
In some surgical settings, aqueous povidone-iodine solution may be considered for incisional wound irrigation in clean and clean-contaminated wounds, though evidence is of low certainty, according to the World Journal of Emergency Surgery 4, 5

For wounds contaminated with human or animal saliva, medical evaluation should be sought as soon as possible, as recommended by the American Heart Association 1
Heavily contaminated wounds may consider povidone-iodine, especially if high risk of infection, as suggested by the World Journal of Emergency Surgery 4, 5

Several studies have not demonstrated a benefit of wound cleansing with povidone-iodine in addition to irrigation, as found by the American Heart Association 1
There is insufficient data to determine the definitive role of saline or povidone irrigation of incisional wounds before closure to prevent surgical site infection, with a Grade of Recommendation 2B, according to the World Journal of Emergency Surgery 3, 5