Evaluation of “Instant” Preparation of the Colon with Povidone-Iodine

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Abstract
The antimicrobial effect of 20 minutes exposure to 10% povidoneiodine solution and to 5% neomycin-erythromycin solution was evaluated in vitro in 6 suspensions of dog feces. Povidone-iodine eliminated aerobic growth (P < 0.001) and reduced anaerobes 4.01 ± 1.06 (P < 0.02); C. perfringens was the only anaerobic organism grown. Forty unprepared dogs underwent resection of the sigmoid colon and primary anastomosis. Twenty received normal saline and 20 povidone-iodine injected intraluminally immediately before resection. The colon contents of povidoneiodine treated dogs grew only 0.07 ± 0.07 aerobes and 3.74 ± 0.49 anaerobes (all Clostridia) (log10/ml colon contents) (P < 0.001). All povidone-iodine dogs survived 3 weeks with no anastomotic leaks; three controls died from anastomotic leak within the first week (P = 0.12). Reexploration of survivors revealed less perianastomotic reaction in the povidone-iodine group. Twenty minutes exposure to povidone-iodine produced a significant decrease in bacterial counts in vivo and in unprepared sigmoid colon. No adverse effects were demonstrated.