Intestinal decontamination using povidone-iodine compromises small bowel storage quality.
BACKGROUND
Povidone-iodine (PI) (Betadine, Purdue Fredrick Co., Norwalk, CT) is used during pancreas transplantation to provide duodenal decontamination without any intestinal complications.


METHODS
This study assessed the combined effect of a luminal pretreatment with PI followed by a proven amino acid (AA)-rich preservation solution on small bowel (SB) storage quality. Rat SB was procured using intra-arterial University of Wisconsin solution followed by luminal administration with combinations of AA+/-PI pretreatment as follows: group 1, 20 mL AA solution; group 2, 20 mL PI and 20 mL AA solution; group 3, 100 mL AA solution; and group 4, 20 mL PI and 100 mL AA solution. Cellular energetics, permeability, and histology were analyzed throughout 10-hr cold storage.


RESULTS
After 10 hr, adenosine triphosphate levels remained 2.9 to 3.2 micromol/g protein lower in the PI-treated groups than in groups 1 and 3. Functional parameters were also negatively affected by PI treatment. Mannitol permeability was 203 and 66 nmol/cm2 per hr in groups 2 and 4 versus 46 and 44 nmol/cm2 per hr in groups 1 and 3. Median grades of histologic injury (Park's) at 10 hr were 3, 5.5, 4, and 5 for groups 1 through 4, respectively. Luminal flushing with PI or AA solution resulted in an equivalent clearance greater than 95% of enteric bacteria present.


CONCLUSIONS
hort-duration luminal PI exposure potentiates SB injury and provides no improved intestinal decontamination.
Olson
David W
DW
Surgical-Medical Research Institute, University of Alberta, Edmonton, Canada.
Kadota
Shin
S
Cornish
Anthony
A
Madsen
Karen L
KL
Zeng
Janice
J
Jewell
Laurence D
LD
Bigam
David L
DL
Churchill
Thomas A
TA
D000818:Animals; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D018988:Bacterial Translocation; D015169:Colony Count, Microbial; D003666:Decontamination; D007421:Intestine, Small / Q000382:microbiology*; D008297:Male; D011206:Povidone-Iodine / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine