Dedo D D, Alonso W A, Ogura J H
Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol. 1977 Jan-Feb;84(1):68-74.
Extensive research has been done to elucidate the cellular and biochemical events of a healing wound. Similarly, new techniques are continually being investigated which would stimulate and augment the reparative process. This paper describes the uses and biochemistry of povidone-iodine which has gained widespread acceptance as a surgical preparation. However, its use as a topical agent for treating head and neck wound infections, dehiscences, and salivary fistulas has gained little recognition. Povidone-iodine is a unique compound formed by binding free iodine to polyvinylpyrrolidone. Previously, the toxic effects of iodine limited its use to preparation of the skin for surgery. When bound to the pyrrolidine molecule, iodine becomes water soluble and markedly less toxic. As a result, the broad antimicrobial spectrum of iodine may be used topically to control wound sepsis. It can be applied to mucosal surfaces without producing burns. The brown color acts as an indicator of its clinical effectiveness. When the dressings become light yellow or pale, free iodine is no longer being released and the dressing should be changed. Povidone-iodine is not a panacea for correcting interruption in the healing process during the postoperative period. The basic management of wound infections, dehiscences, and fistulas remains unchanged. Incision and drainage, debridement and flap contracture, lateralization, and diversion are necessary to initiate the healing process. Familarity with each phase of healing provides the basis for managing each of these surgical problems. Topical povidone-iodine not only controls wound sepsis but augments wound healing. The physiologic correlation with each phase of wound healing for these various surgical problems is elaborated and clinical cases presented.
为阐明愈合伤口的细胞和生化事件，人们已开展了广泛研究。同样，新技术也在不断被探索，以刺激和增强修复过程。本文描述了聚维酮碘的用途及生物化学性质，它作为一种手术前准备用药已获得广泛认可。然而，其作为治疗头颈部伤口感染、伤口裂开及唾液瘘的局部用药却鲜为人知。聚维酮碘是一种通过将游离碘与聚乙烯吡咯烷酮结合而形成的独特化合物。以前，碘的毒性作用限制了其仅用于手术前皮肤准备。当与吡咯烷分子结合后，碘变得可溶于水且毒性显著降低。因此，碘的广泛抗菌谱可用于局部控制伤口感染。它可应用于黏膜表面而不会引起灼伤。棕色可作为其临床疗效的指示剂。当敷料变为浅黄色或变淡时，表明不再释放游离碘，此时应更换敷料。聚维酮碘并非解决术后愈合过程中断问题的万灵药。伤口感染、裂开及瘘管的基本处理方法仍未改变。切开引流、清创及皮瓣挛缩、侧方移位和改道对于启动愈合过程是必要的。熟悉愈合的各个阶段为处理这些外科问题奠定了基础。局部应用聚维酮碘不仅能控制伤口感染，还能促进伤口愈合。本文阐述了这些不同外科问题与伤口愈合各阶段的生理相关性，并列举了临床病例。
