Transcutaneous iodine absorption in adult patients with thyroid cancer disinfected with povidone-iodine at operation.
Povidone-iodine is used as disinfection in patients undergoing many kinds of operations. Several cases of thyroid dysfunction induced by transcutaneous absorption of povidone-iodine have been reported in small infants. However, transcutaneous absorption was not clearly reported in adults. The aim of this study was to assess transcutaneous absorption of iodine in patients who received single topical application with povidoneiodine and serial changes of urinary iodine excretion under the condition with a simple iodine-restricted diet in Japan, an iodine-sufficient area. Sixty-eight patients with thyroid carcinoma undergoing total thyroidectomy received single skin disinfection with either povidone-iodine (group A; n = 47) or chlohexidine gluconate, a noniodine containing biguanide (group B; n = 21). In group A, urinary iodine excretion on the first day after operation increased up to 7 times that of the preoperative value. The amounts of urinary iodine correlated positively with operating time. Increased urinary iodine, however, returned to preoperative values on the third or fifth day after operation. In group B, there was no increase in urinary iodine excretion and urinary iodine excretion was ranged from 54 to 193 microg/g of creatinine on the third day of operation. In conclusion, a large amount of povidone-iodine was absorbed through healthy skin even in adults. This may possibly interfere with scintigraphy or radioactive iodine treatment, or cause thyroid disinfection in susceptible patients.
Tomoda
Chisato
C
Kuma Hospital, Kobe, Japan. tomoda@kuma-h.or.jp
Kitano
Hiroya
H
Uruno
Takashi
T
Takamura
Yuuki
Y
Ito
Yasuhiro
Y
Miya
Akihiro
A
Kobayashi
Kaoru
K
Matsuzuka
Fumio
F
Amino
Nobuyuki
N
Kuma
Kanji
K
Miyauchi
Akira
A
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007455:Iodine / Q000652:urine; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D011300:Preoperative Care; D012869:Skin Absorption / Q000502:physiology*; D013961:Thyroid Gland / Q000601:surgery; D013964:Thyroid Neoplasms / Q000601:surgery* / Q000652:urine; D013965:Thyroidectomy
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D007455:Iodine