Abstract
To evaluate the effects of povidone-iodine (PI) enema on the bacterial flora of colorectal mucosa, the authors studied 113 patients who were candidates for colorectal surgery. The study of the rectum included 72 patients. Total bacterial concentrations after a PI enema (N=44) were significantly lower than after a simple water enema (N=12,P<0.001), or than after a water enema associated with intravenous metronidazole (N=16,P<0.01). The study of the colon included 41 patients. Total bacterial concentrations did not differ after a PI enema (N=24) than after a water enema (N=11); both groups were associated with intravenous metronidazole. In contrast, both preparations significantly reduced bacterial concentrations when compared with oral administration of polyethyleneglycol (N=6,P<0.01). Similar results were observed in rectal and colonic studies, when analysis was restricted to the anaerobic flora. PI is an antiseptic that, when administered alone in an enema or in association with metronidazole, significantly reduces bacterial concentrations in the mucosa of the colon and rectum. It may be proposed as a simple preoperative preparation for colorectal surgery.
Similar content being viewed by others
References
Bartlett JP, Burton RC. Effects of prophylactic antibiotics on wound infection after elective and rectal surgery. Am J Surg 1983;245:300–9.
Arango A, Lester JL, Martinez OV, Milinin TI, Zeppa R. Bacteriologic and systemic effects of intraoperative segmental bowel preparation with povidone-iodine. Arch Surg 1979;114:154–7.
Gilmore OJ, Sanderson PJ. Prophylactic interparietal povidone-iodine in abdominal surgery. Br J Surg 1975;62:792–9.
Gray JG, Lee MR. The effect of topical povidone-iodine in wound infection following abdominal surgery. Br J Surg 1981;68:310–3.
Baum ML, Anish DS, Chalmers TC, Sacks HS, Smith H Jr, Fagerston RM. A survey of clinical trials of antibiotic prophylaxis in colon surgery: evidence against further use of no-treatment controls. N Engl J Med 1981;305:795–9.
Cortese F, storelli G, Turra G, Contini S, Botta GC. Valutazione clinica sull'impiego di un antrettico iodato nelle preparazione chirurgica del grosso intestino. Gaz Med Ital 1982;141:299–304.
Jones FE, De Cosse JJ, Condon RE: Evaluation of “instant” preparation of the colon with povidone-iodine. Ann Surg 1976;184: 74–9.
Scammel BE, Phillips RP, Brown R, Burdon DW, Keighley MR, Influence of rectal washout on bacterial counts in the rectal stump. Br J Surg 1985;72:548–50.
Edmiston CE, Avant GR, Wilson FA. Anaerobic bacterial population on normal and diseased human biopsy tissue obtained at colonoscopy. Appl Environ Microbiol 1982;43:1173–81.
Gilmore OJ, Rosin RD, Exarchakos G, Ellis H. Colonic anastomosis healing: the effect of topical povidone-iodine. Eur Surg Res 1978;10:94–104.
Bunodiere M, Roullet-Audy JC, Dreux B, et al. Le traitement des péritonites aiguës par antisepsie péritonéale a l'aide d'une solution de polyvinyle-pirrolidone iodée. A propos de 175 observations. Ann Chir 1979;33:293–7.
Zamora JL, Price MF, Chuang P, Gentry LO. Inhibition of povidone-iodine's bactericidal activity by common organic substances: an experimental study. Surgery 1985;98:25–9.
Author information
Authors and Affiliations
About this article
Cite this article
Hay, JM., Boussougant, Y., Lacaine, F. et al. Povidone-iodine enema as a preoperative bowel preparation for colorectal surgery. Dis Colon Rectum 32, 9–13 (1989). https://doi.org/10.1007/BF02554714
Issue Date:
DOI: https://doi.org/10.1007/BF02554714