Evaluation of Postoperative Povidone-Iodine in Adjustable Suture Strabismus Surgery to Reduce Suture Colonization A Randomized Clinical Trial

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dc.citation.issue10
dc.citation.volume134
dc.contributor.authorRossetto, Julia Dutra [UNIFESP]
dc.contributor.authorSuwannaraj, Sirinya
dc.contributor.authorCavuoto, Kara M.
dc.contributor.authorSpierer, Oriel
dc.contributor.authorMiller, Darlene
dc.contributor.authorMcKeown, Craig A.
dc.contributor.authorCapo, Hilda
dc.coverageChicago
dc.date.accessioned2020-07-31T12:47:39Z
dc.date.available2020-07-31T12:47:39Z
dc.date.issued2016
dc.description.abstractIMPORTANCE Although the association between suture colonization and postoperative infections remains hypothetical, measures to reduce perioperative suture colonization may minimize postoperative infections. The suture colonization rate in adjustable suture strabismus surgery is not well defined, and the effect of povidone-iodine use on suture colonization is unknown. OBJECTIVE To assess whether povidone-iodine application at the end of adjustable suture strabismus surgery decreases the suture colonization rate. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial designed in 2015 and performed from June 1 through October 31, 2015, a total of 65 adjustable and 43 control suture specimens from 65 demographically similar adults undergoing adjustable suture strabismus surgery were studied. A random sampling assigned participants into group 1 (with povidone-iodine) or group 2 (without povidone-iodine) at the end of surgery. A control suture specimen was obtained if ipsilateral nonadjustable surgery was performed. Both groups received antibiotic ointment at the end of the procedure. No patients refused participation or withdrew. Data analysis was performed from October 1 to December 31, 2015. Observers were unaware of patient grouping. INTERVENTIONS One drop of 5% povidone-iodine directly over the sliding noose of the adjustable suture at the end of surgery. MAIN OUTCOMES AND MEASURES The suture colonization rate after adjustment in group 1, group 2, and the control group. RESULTS Of 65 adults undergoing surgery, there were 17 men (49%) and 18 women (51%) in group 1 and 10 men (33%) and 20 women (67%) in group 2, as well as 20 men (47%) and 23 women (53%) in the control group. The mean (SD) age of the patients was 48.5 (16.8) years in group 1, 46.6 (18.1) years in group 2, and 47.7 (17.0) years in the control group. There was no difference in the colonization rate between group 1 (57%) and group 2 (47%) (relative risk [RR], 1.1en
dc.description.abstract95% CI, 0.6-1.7en
dc.description.abstractP = .80), group 1 and the control group (44%) (RR, 1.0en
dc.description.abstract95% CI, 0.5-1.8en
dc.description.abstractP > .99), or group 2 and the control group (RR, 1.3en
dc.description.abstract95% CI, 0.8-2.1en
dc.description.abstractP = .62). Eleven bacterial species were identified. Staphylococcus epidermidis was the predominant isolate (40 of 56 [71%]). A longer interval between the end of surgery and adjustment was associated with higher culture positivity (6.3 hours in positive vs 4.4 hours in negative cultures, P = .001)en
dc.description.abstracthowever, there was no difference in bacterial growth between the groups. No adverse effects of povidone-iodine were observed. CONCLUSIONS AND RELEVANCE This study was not able to demonstrate that povidone-iodine at the end of adjustable suture strabismus surgery reduces the suture colonization rate.en
dc.description.affiliationUniv Miami, Miller Sch Med, Dept Ophthalmol, Bascom Palmer Eye Inst, 900 NW 17th St, Miami, FL 33136 USA
dc.description.affiliationUniv Fed Sao Paulo, Dept Ophthalmol & Visual Sci, Sao Paulo, Brazil
dc.description.affiliationKhon Kaen Univ, Dept Ophthalmol, Fac Med, Khon Kaen, Thailand
dc.description.affiliationTel Aviv Univ, Div Ophthalmol, Tel Aviv Med Ctr, Sackler Fac Med, Tel Aviv, Israel
dc.description.affiliationUnifespDepartment of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.description.sponsorshipNational Institutes of Health (NIH)
dc.description.sponsorshipResearch to Prevent Blindness
dc.description.sponsorshipIDNIH: P30EY014801
dc.format.extent1151-1155
dc.identifierhttp://dx.doi.org/10.1001/jamaophthalmol.2016.2926
dc.identifier.citationJama Ophthalmology. Chicago, v. 134, n. 10, p. 1151-1155, 2016.
dc.identifier.doi10.1001/jamaophthalmol.2016.2926
dc.identifier.issn2168-6165
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56980
dc.identifier.wosWOS:000386486900019
dc.language.isoeng
dc.publisherAmer Medical Assoc
dc.relation.ispartofJama Ophthalmology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleEvaluation of Postoperative Povidone-Iodine in Adjustable Suture Strabismus Surgery to Reduce Suture Colonization A Randomized Clinical Trialen
dc.typeinfo:eu-repo/semantics/article
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