John:

I recently reported that Betadine straight from the bottle into a wound was considered caustic to tissue and should therefore be diluted. Well, today (July 5, 2004 at 0100 MST) I spoke with the Doc at the ER and learned the "old school" of thought were along those lines. Seems in the late 1980's a series of anaphylactic reactions to iodine were noted. This subsequently led to an investigation by the FDA. The hospitals and clinics were quick to adopt the idea of diluted Betadine. In about 1998 it became recognized through product research to return to using Betadine full strength. Now a wound is irrigated (depending on the need and amount of debris) and just prior to closure about 10cc of Betadine is literally dumped in and after about 2 minutes it is rinsed out and the wound closed. CAUTION: Be sure your patient is not allergic to iodine, or shellfish, as this may cause problems.

I learned two things today…

One: I was still under the “old school of thought” and should therefore consider full strength Betadine in wound irrigation. About 10cc should work, anymore and you need professional help.

Two: When you are in the ED at 0100 with a heart attack (transported by ambulance) and the Doc is getting ready to suture a wound closed, you can learn something from them while they suture if they know you and are willing to instruct. BTW I observed the doc literally flush the wound with Betadine and then flush with sterile water.

Hope this clears the air yet again and the Doc did refer me to the website as you have. HMMMMMMM

I apologize to you (and all) if I caused any confusion and gave incorrect information.

Stargazer