Povidone-Iodine (Burns)

How it works

It releases free iodine that oxidises microbial proteins and nucleic acids, giving broad antimicrobial activity against bacteria, fungi and viruses on the wound surface.

Prescribing in practice

• Significant systemic iodine absorption can occur when applied to large burns or denuded areas, risking thyroid dysfunction and, in renal impairment, iodine accumulation, so avoid extensive or prolonged application over major burns.
• Use with particular caution in neonates, pregnancy and breastfeeding because of fetal and neonatal thyroid sensitivity, and avoid in known iodine sensitivity and thyroid disorders.
• Some preparations may impair keratinocyte function and wound healing with heavy or repeated use, so confine use to appropriate antiseptic indications.

Monitoring

Monitor for signs of excessive absorption, including thyroid function where large areas are treated or use is prolonged, and watch the periwound skin for irritation.

Counselling the patient

• This antiseptic helps reduce germs on the wound or skin before procedures.
• Team: limit area and duration over large burns and use caution in thyroid disease, pregnancy and the very young.
• Report any skin reaction or known iodine allergy.

Evidence & guidelines

Povidone-iodine is an established antiseptic; cautions over absorption and thyroid effects on large or broken skin areas are detailed in current prescribing references.