Benefit and harm of iodine in wound care: a systematic review

Nowadays many products are available to combat infections and thus to promote wound healing. Iodine is one of these products, but reports are conflicting as to the effectiveness and adverse effects of iodine in the treatment of wounds. A systematic review was performed of 27 randomised clinical trials, reporting on chronic, acute, burn wounds, pressure sores, and skin grafts. Main outcome parameters were wound healing, bacterial count, and adverse effects. Iodine did not lead to a reduction or prolongation of wound-healing time compared with other (antiseptic) wound dressings or agents. In individual trials, iodine was significantly superior to other antiseptic agents (such as silver sulfadiazine cream) and non-antiseptic dressings, but seemed inferior to a local antibiotic (Rifamycin SV MMX(®)) and, when combined with alcohol, to crude honey in reducing bacterial count and/or wound size. Adverse effects, including thyroid function derailment, did not occur more frequently with iodine. Based on the available evidence from clinical trials, iodine is an effective antiseptic agent that shows neither the purported harmful effects nor a delay of the wound-healing process, particularly in chronic and burn wounds. The antiseptic effect of iodine is not inferior to that of other (antiseptic) agents and does not impair wound healing. Hence, iodine deserves to retain its place among the modern antiseptic agents.