TY  - JOUR
T1  - Genitoüriner cerrahide kullanılan povidon iyodürün tiroid hormonları üzerine etkisi var mıdır?
TT  - Are there any effect of povidone iodine used in genitourinary surgery on thyroid hormones?
AU  - Türkoğlu, Ali Rıza
AU  - Çoban, Soner
AU  - Asan, Ali
AU  - Güzelsoy, Muhammet
AU  - Üstündağ, Yasemin
AU  - Öztürk, Murat
AU  - Demirci, Hakan
PY  - 2018
DA  - February
JF  - Yeni Üroloji Dergisi
JO  - New J Urol.
PB  - Ali İhsan TAŞÇI
WT  - DergiPark
SN  - 1305-2489
SP  - 34
EP  - 38
VL  - 13
IS  - 1
LA  - tr
AB  - Amaç: Povidon iyodür (PI) bir çok cerrahi operasyon öncesinde kullanılan bir antiseptiktir. Iyodun deriden absorbe olabildiği bilinmektedir. Bu çalışmada, skrotal deriyi içeren genitoüriner bölge cerrahisinde antiseptik olarak kullanılan PI’nın tiroid hormonları üzerine etkisini incelemeyi amaçladık. Aynı zamanda diğer bir antiseptik olan klorheksidin glokonat (CHG) ile PI’yı antiseptik özelliği yönünden karşılaştırdık.Gereç ve Yöntemler: Herhangi bir tiroid patolojisi olmayan 77 hasta çalışmaya dahil edildi. Hastalar rastgele iki gruba bölündü. Grup A deri antiseptiği olarak PI kullandığımız 46 hasta, Grup B de CHG kullandığımız 31 hastadan oluşmakta idi. Hastaların göbek ile diz arası, skrotumu içine alacak şekilde, 50 ml antiseptik ile boyandı. PI grubunda operasyondan bir gün önce, operasyondan bir gün ve on dört gün sonra, serbest T3 (sT3), serbest T4 (sT4) ve tiroid stimulan hormon (TSH) düzeyleri ölçüldü. İki grup, yara yeri antiseptik etkinliği açısından karşılaştırıldı. Bulgular: Grup A da, sT3 düzeyi operasyondan 1 gün sonra anlamlı olarak düştü ( preop: 3.45±0.47 pg/ml vs postop 1. gün: 2.70±0.44 pg/ml, p=0.001). Postoperatif 14 üncü gün bazal değere yaklaştı (3.40±0.3 pg/ml, p=0.05). Buna karşın TSH ve sT4 değerlerinde istatistiksel fark yoktu. Her iki grupta Hastalık Kontrol ve Korunma Merkezi (Centers for Disease Control and Prevention) kriterlerine göre cerrahi alan enfeksiyonu saptanmadı.Sonuç: Araştırmamızda PI, sT3 düzeylerini anlamlı derecede azaltmıştır. Bu nedenle cerrahi alan temizliğinde PI yerine CHG kullanılması önerilebilir.
KW  - Povidone iyodür
KW  - klorheksidin diglukonat
KW  - tiroid hormonları
N2  - Aim: Povidone-iodine (PI) is a preoperativetopical antiseptic used in many surgical operations.It is known that iodine can be absorbed byskin. In this study, we aimed to investigate theeffect of PI on thyroid hormones during genitourinarysurgery incluiding scrotal skin. We alsocompared the antiseptic effect of PI and Chlorhexidineglauconate (CHG).Material and Methods: Seventy-seven patientswithout any thyroid disease were includedin this study. The patients were divided into twogroups by random allocation. Group A included46 patients that uset PI and group B 31 patientsthat used CHG for skin disinfection. Theoperative site from umblicus to knee includingscrotum painted with 50 ml of antiseptic solution.Thyroid stimulating hormone (TSH), freeT3 (fT3) and free T4 (fT4) hormone levels weremeasured on the day before the operation andon the 1st and 14th day of postoperative periodin the PI group. Two groups were compared forwound antiseptic efficacy.Results: One day after the operation,fT3levels decreased significantly (preop: 3.45±0.47pg/ml vs postop 1st day: 2.70±0.44 pg/ml,p=0.001) in group A. Post op 14th day, fT3 levelsreturned to basal value (3.40±0.3 pg/ml,p=0.05). However there was no significant differencein TSH and fT4 levels. In both groups nosurgical site infections as defined by the Centersfor Disease Control and Prevention (CDC) wasdeveloped.Conclusion: In our study, PI significantlyreduced sT3 levels. For this reason, it may beadvisable to use CHG instead of PI for cleaningthe surgical field.
CR  - 1. Tomoda C, Kitano H, Uruno T et al. Transcutaneous iodine absorption in adult patients with thyroid cancer disinfected with povidone-iodine at operation. Thyroid 2005;15:600–3.
CR  - 2. Georgiade GS, Georgiade NG, Grandy RP et al. The effect of povidone-iodine solutions used as surgical preparations on the bacterial flora of the skin. Adv Ther 1990;7:1–8.
CR  - 3. Findik G, Gezer S, Aydogdu K et al. Effect of intrapleural povidone-iodine lavage on thyroid hormones in thoracic surgery. Thorac Cardiovasc Sur 2010;58:225–8.
CR  - 4. Guy E. Abraham. The bioavailability of |odine applied to the skin. Original Intern 2008;15:77–9.
CR  - 5. Below H, Behrens-Baumann W, Bernhardt C et al. Systemic iodine absorption after preoperative antisepsis using povidone-iodine in cataract surgery – an open controlled study. Dermatology 2006; 212: 41 –6.
CR  - 6. Findik RB, Yilmaz G, Celik HT et al. Effect of povidone iodine on thyroid functions and urine iodine levels in caesarean operations. Maternal-fetal nonatal medicine, Doi; 10.3109/14767058.2013
CR  - 7. Pietsch J, Meakins JL. Complications of povidone-iodine absorption in topically treated burn patient. Lancet I 1976;280–28,
CR  - 8. Aiba M, Ninomiya J, Furuya K et al. Induction of a Critical Elevation of Povidone-Iodine Absorption in the Treatment of a Burn Patient: Report of a Case. Jpn J Surg 1999;29:157–9.
CR  - 9. Bilgehan H: Klinik Mikrobiyolojik Ta111, 2. bask1, s. 35, Banş Yayınları, Izmir 1995.
CR  - 10. Vaizoğlu O. Deriden ilaç penetrasyonuna etki eden faktörler. Dermatolojide Gelişmeler -2, 1993, İstanbul. Teknografik Matb. İstanbul.1993:185-91.
CR  - 11. Bergstrom KG, Strober BE. Fitzpatrick’s Dermatology in General Medicine Eds. Wolff K, Goldsmith LA et al. 7. Baskı, McGraw Hıll Newyork. 2008:2091-146.
CR  - 12. Berríos-Torres SI, Umscheid CA, Bratzler DW et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. Published online, May 3, 2017.
CR  - 13. Tomoda C, Kitano H, Uruno T et al. Transcutaneous iodine absorption in adult patients with thyroid cancer disinfected with povidone-iodine at operation. Thyroid 2005;15:600–3.
CR  - 14. Gosset M, Bentayeb H, Poulet C et al. An unusual complication of thoracostomy. Rev Mal Respir 2008;25:344–6.
CR  - 15. Vorherr H, Vorherr UF, Mehta P et al. Vaginal absorption of povidone-iodine. J Am Med Assoc 1980;244:2628–9.
CR  - 16. Nobukuni K, Kawahara S. Thyroid function in nurses: the influence of povidone-iodine hand washing and gargling. Dermatology 2002;204:99–102.
CR  - 17. Erdoğan MF, Tatar FA, Unlütürk U et al. The effect of scrubbing hands with iodine-containing solutions on urinary iodine concentrations of the operating room staff. Thyroid. 2013;23:342-5
CR  - 18. Prager EM, Gardner RE. Iatrogenic hypothyroidism from topical iodinecontaining medications. West J Med 1979;130:553–5.
CR  - 19. Tsunoda A, Shibusawa M, Kamiyama G et al. Iodine absorption after intraoperative bowel irrigation with povidoneiodine. Dis Colon Rectum 2000; 43: 1127–32.
CR  - 20. Pietsch J, Meakins JL. Complications of povidone-iodine absorption in topically treated burn patients. Lancet 1976; 1:280–1.
CR  - 21. Scoggin C, McClellan JR, Cary JM. Hypernatraemia and acidosis in association with topical treatment of burns. Lancet 1977;1: 959
CR  - 22. Bayliff CD, Sibbald WJ, Mills DG et al. Electrolyte abnormalities following povidone-iodine topical therapy. Drug Intell Clin Pharm 1981;15:801–2.
CR  - 23. Oyama T, Shibata S, Matsuki A et al. Serum endogenous thyroxine levels in man during anaesthesia and surgery. Br J Anaesth 1969;41:103–8.
CR  - 24. Hanazaki, K, Shingu, K, Adachi W et al. Chlorhexidine dressing for reduction in microbial colonization of the skin with central venous catheters: Chlorhexıdıne Versus Povıdone-Iodıne. J Hosp Infect. 1999;42:165-8.
CR  - 25. Maki DG, Ringer M, Prospective randomized trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 1991;338: 339-43.
CR  - 26. Garland J.S, Alex C.P, Mueller C.D et al. A randomized trial comparing povidoneiodine to a chlorhexidine-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001;107:1431-6.
CR  - 27. Chaiyakunapruk N, Veenstra D.L, Lipsky B.A. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: Ann Intern Med 2002;136:792-801.
CR  - 28. Ersöz ŞE, Akkaya A, Koçoğlu E et al. Oktenidin hidroklorür, klorheksidin diglukonat ve povidon iyodürün, santral ve periferik venöz kateter uygulamalarında antiseptik etkilerinin karşılaştırılması. Abant Medical Journal 2016;5:16-22.
UR  - https://dergipark.org.tr/en/pub/yud/issue//520450
L1  - https://dergipark.org.tr/en/download/article-file/638620
ER  -