With the emergence of multidrug-resistant strains of organisms and a better understanding of the dynamics of wound healing, there has been an interest in topical use of iodine in wound care. Radhakrishnan Raju and Coll. conducted this prospective, randomized, open-label clinical trial was conducted at 8 cities across 15 institutions in India from March 2016 to March 2017. The results of this study show that both formulations of cadexomer iodine (ointment and powder) are safe and effective in the treatment of chronic ulcers.
Chronic wounds, diabetic foot ulcers, venous leg ulcers and pressure ulcers are the most common wounds.
Infection control is required in chronic wound treatment, but there is not any evidence to use of systemic antibiotics for the treatment of chronic wounds. On the contrary, literature gives credence to the use of topical preparations with potential advantages. With the emergence of multidrug-resistant strains of organisms and a better understanding of the dynamics of wound healing, there has been an interest in topical use of iodine in wound care. Among the iodine preparations, povidone-iodine was first introduced in the 1960s and cadexomer iodine in the 1980s.
Radhakrishnan Raju and Coll. conducted this prospective, randomized, open-label clinical trial was conducted at 8 cities across 15 institutions in India from March 2016 to March 2017. One hundred and twenty four patients were randomized in 3 different groups. The first one included patients treated with 0.9% cadexomer iodine ointment plus standard care (n = 41). The second group included patients treated with 0.9% cadexomer iodine powder plus standard care (n = 43). The third group included patients treated with standard care alone (n = 40). 116 patients completed the maximum treatment period of 12 weeks. A total of 27 adverse events were reported by 17 patients. Major adverse reactions included burning pain (44.4%), irritation and itching (18.5%).
The results showed that ulcer size was reduced from baseline to the primary endpoint of 12 weeks. It was significantly higher with both formulations of cadexomer iodine ointment (94.3% ± 10.6%) and powder (90.4% ± 14.9%) as compared with standard care alone (67.8% ± 21.8%). Moreover, the percentage of patients with complete wound healing at the end of the 12 weeks was significantly higher in patients treated with both formulations of cadexomer iodine ointment (65.8%) and powder (58.1%) as compared with standard care alone (20.0%).
The results of this study show that both formulations of cadexomer iodine (ointment and powder) are safe and effective in the treatment of chronic ulcers.
Raju R, Kethavath SN, Sangavarapu SM, Kanjarla P. Wounds. 2019 Mar; 31(3):85-90.