ABSTRACT
According to orthopedists' reports, substitution of the original for a generic povidone-iodine (PVP-I) disinfectant could have led to some adhesion problems of antimicrobial incise drapes on the field of operation with the consequence of increasing the infection risk. Three methods have been used to assess the case: (a) a gas chromatography/mass spectrometry (GC-MS) approach quantifying methimazole formation from carbimazole, (b) in vitro adhesion experiments on a smooth glass plate surface and (c) the analysis of intrasurgical procedures. GC-MS results confirmed the higher potency of the original compared to the generic PVP-I. In vitro comparison of the adhesion on a PVP-I-pretreated glass surface showed no difference between the disinfectants and no significant destruction of the adhesive layer. However, due to different surgery preparation procedures, the remaining free skin surface granting sufficient adhesion differed if the intervening surgeon himself or his assistant prepared the field of operation. As a conclusion, the original PVP-I disinfectant is confirmed as the first-choice disinfectant for the field of operation. Adhesion problems were arising with new surgical staff and thus different preparation procedures. Exchanging PVP-I disinfectants cannot explain the adhesion problems of drapes and antimicrobial incise foils on the skin.
