POVIDONE-IODINE AND SKIN DISINFECTION BEFORE INITIATION OF EPIDURAL-ANESTHESIA

Background: Povidone iodine (PI) solution is used commonly for skin di sinfection before epidural and spinal anesthesia. Although there have been reports indicating the presence of microbial contaminants in PI s olution, none have evaluated the prevalence of PI contamination. The a ims of this study were to assess the frequency of bacterial contaminat ion of previously opened bottles of PI solution and to compare the eff ectiveness of new and previously opened bottles of PI solution for ski n disinfection. Methods: Twenty previously opened and ten previously u nopened multiple-use bottles of PI solution were evaluated for microbi al contamination. In addition, final swabs and PI solution used for sk in disinfection in 80 patients undergoing elective epidural analgesia were evaluated. Results: The inside of the bottle cap or the PI soluti on from 40% of the multiple-use PI bottles in use were contaminated. T here was no growth from any previously unused PI bottles. Povidone iod ine from newly opened bottles provided more effective skin decontamina tion than did solution from previously opened bottles. Conclusions: Mu ltiple-use PI bottles in normal use may become contaminated by bacteri a. In addition, PI solution from previously opened bottles was less ef fective than PI from previously unopened bottles. Based on these findi ngs, if PI solution is chosen for skin antisepsis before initiation of epidural and spinal anesthesia, only single-use containers should be used.