Povidone-iodine related burns

Skin preparation burns associated with chemical agents are uncommon. They o ccur most frequently in patients placed in the lithotomic position undergoi ng gynaecologic or urologic operations, the burn being on the buttocks, and in those undergoing orthopaedic operations, the burn being on the extremit ies and under a tourniquet. The basic mechanism involves irritation coupled with maceration and pressure. If the betadine solution has not been allowe d to dry and has been trapped under the body of the patient in a pooled dep endent position, such as the buttocks or under a tourniquet, the solution m ay irritate the skin and result in a skin burn. The irritation coupled with pressure leads to a situation analogous to that seen in the development of an acute accelerated decubitus ulcer; irritation, maceration, friction and pressure compounding each other to result in a skin burn or superficial ul cer in the skin. Our experience with three illustrative patients who presen ted with various burns following exposure to povidone-iodine (betadine) is described below. (C) 2001 Elsevier Science Ltd and ISBI. All rights reserve d.