Lacerations: wound cleaning with povidone-iodine reduced infections.

Clinical bottom line (level 1b)

  1. Patients with sutured lacerations who had wound cleaning with povidone-iodine were less likely to have subsequent wound infection (NNT = 10 at 14 days) , or a purulent wound (NNT = 19 at 14 days) .
Gravett et al: Annals of Emergency Medicine 1987; 16: 167-171
Expires December 2004

The study

Unblinded ?concealed randomised trial without intention-to-treat
Setting: emergency department, acute hospital, USA

500 patients (aged mean 31 years, ?% male) lacerations requiring sutures
Control Group: (n = , 194 analysed): saline clean
Experimental Group: (n = ., 201 analysed): 1% povidone-iodine instilled into wound, and solution rubbed into wound using sterile gauze for 60 seconds
All patients had antiseptic skin cleaning, local anaesthetic with 1%lidocaine before suturing. Sutured wounds were covered with a sterile dressing.
79% followed for 4-14 days until sutures removed
Outcome notes:
  • infected wound : redness with swelling, tenderness, erythema and warmth

The evidence

Outcome Time to outcome CEREERRRR
(95% CI)		ARR
(95% CI)		NNT
(95% CI)
infected wound 14 days 30
(15.5%)		 11
(5.47%)		 65%
(31% to 82%)		 9.99%
(4.01% to 16.0%)		 10
(6 to 25)
purulent wound 14 days 12
(6.19%)		 2
(1.00%)		 84%
(29% to 96%)		 5.19%
(1.53% to 8.85%)		 19
(11 to 65)

  • No comments on side-effects.

    • Citation

    1. Gravett A, Sterner S, Clinton JE, et al: A trial of povidone-iodine in the prevention of infection in sutured lacerations. Annals of Emergency Medicine 1987; 16: 167-171
    Contributor: Chris Ball and Clare Wotton, December 2000
    Reviewer:

    Clinical Question.
    Patient lacerations
    Intervention or Exposure povidine-iodine
    Comparison saline
    Outcome infection