Postoperative Skin Reactions Related to Povidone Iodine

Abstract

This letter presents a rare postoperative skin reaction following surgical skin preparation with 10% povidone-iodine, a broad-spectrum topical antiseptic widely used to sterilise the surgical site. The authors note that povidone is an allergenic agent and that, in people with hypersensitivity, it can cause skin sensitivity, irritant contact dermatitis, allergic dermatitis, urticaria, anaphylaxis, necrosis and chemical burns in pressure areas, complications that prolong hospital stay and increase costs. The case concerns an 11-year-old boy with no history of allergies who underwent inguinal hernia surgery under general anaesthesia with a laryngeal mask; the surgical area was prepared with 10% povidone-iodine and a heating blanket was kept at 36-38°C during the procedure, which lasted about 30 minutes. Four to five hours after surgery, a burn-like brown discolouration and skin change were noticed in both gluteal regions, and these had resolved by the next morning. Citing similar cases, the authors explain that such reactions are associated with wet surgical drapes that have absorbed povidone-iodine remaining in contact with the skin, and with higher iodine concentrations. They recommend avoiding spillage when cleaning the surgical area, covering with sterile drapes only after the povidone-iodine has dried, regularly checking and recording the heating temperature, and careful adherence to standard skin preparation steps by the whole operating room team.

Abstract prepared by the editorial office from the full text of the article; the authors did not supply one.