Dilute Povidone-Iodine Solution Soaking Is Ineffective in Improving Outcomes of Necrotizing Fasciitis Caused by Diabetic Foot

Wen Yu Lin, Chun Yu Ma, Wei Chieh Fang, Tien Hsiang Wang, Yu Chung Shih, Chih Hsun Lin, Szu Hsien Wu, Cherng Kang Perng, Ching En Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Wound soaking is a physical debridement method that helps reduce bacterial colonization and consequently promotes wound healing. Although soaking in povidone-iodine solution was ineffective in reducing bacterial colonization in acute trauma wounds, there is still a lack of evidence supporting the efficacy of this method in treating severe soft tissue infection. This study aimed to explore the effects of wound soaking in 1% dilute povidone-iodine solution on necrotizing fasciitis caused by diabetic foot ulcers. We retrospectively reviewed and finally included 153 patients who were admitted because of diabetic foot ulcers after undergoing fasciotomy for necrotizing infection from January 2018 to December 2021. Results showed no statistical difference in the outcomes between patients in the soaking and nonsoaking groups. End-stage renal disease (P = 0.029) and high serum C-reactive protein level (P = 0.007) were the only independent factors for below-knee amputation in the univariate and multivariate logistic regression analyses. Therefore, soaking diabetic wounds with severe infection in 1% dilute povidone-iodine solution may not reduce the hospital length of stay, risk of below-knee amputation, and readmission rate.

Original languageEnglish
Pages (from-to)S37-S40
JournalAnnals of plastic surgery
Volume92
Issue number1
DOIs
StatePublished - 1 Jan 2024

Keywords

  • diabetic foot
  • necrotizing fasciitis
  • povidone-iodine
  • soaking

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